Laserfiche WebLink
12. What is the depth to groundwater? I1/v F rw 1 t <br /> Describe the source of information: <br /> 13. Are there any water wells on this parcel or adjacent properties? �XKZAM-*f YES [ ] NO [ ) <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> WWell ft <br /> ft <br /> h- <br /> ft ft <br /> 14. Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ ) NOV <br /> 15. Indicate the responsible party to be billed for additional PHS-EHD staff time expended beyond 3 hour minimum <br /> permit payment per tank. If the party designated below is different than the permit applicant, e.g. property <br /> owner, the parrymust acknowledge this responsibility for the billing by signature and date below. <br /> Name � 1 F o 0 AV-,PT l <br /> 4� T �� � <br /> Mailing Address T1C1 & X C4 ° 95 <br /> Day Phone Number 3-IJ ,p3 <br /> _ <br /> Umjue-Ttp, <br /> Si, a re Tid Date <br /> I <br /> EH 23 046 (Revised 7/10/96) Page 6 <br />