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12. What Is the depth to groundwater? Unknown by contractor <br />Describe the source of Information_ tt_6-9* a4 <br />r"VN � a"41 ::�'p ctt,-C <br />13. Are there any water wells on U& parcel or adjacent <br />TYPE OF WELLS <br />DISTANCE TO TANKS(S) <br />Public Well <br />ft. <br />Private Well <br />ft. <br />Irrigation Well <br />ft. <br />Monitoftg Well <br />It. <br />other <br />rL <br />YES[ j NO[ jX <br />14. Will the ta*s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ j NON <br />15. Indicate the responsible party to be billed for additional PHS-EHD staff time expended beyond 3 hoar minimum permit payment <br />per tack. If the party designated below Is different than the permit appiicant, e.g. property owner, the party must acknowledge <br />this responsibility for the billing by signature and date below. <br />Name St John's Episcopal Church <br />Mailing Address 316 N. E1 Dorado St., Stockton. CA 95202 <br />Day Phone Number( 209 ) 466-6916 <br />EH 23 046 (Revised 10/19/98) Page 6 <br />