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12. What is the depth to groundwater? <br /> 4 -to 6 FT. <br /> Describe the source of information: <br /> 3 &/DA-- i TY 0r- 7X,4c� <br /> 13. Are there any water wells on this parcel or adjacent properties? ITS [ ] NO [ ] <br /> TYPE OF Wlii T S DISTANCC TO TANKS(S) <br /> Public Well O ft. <br /> Private Well Q ft. <br /> Irrigation Well O ft. <br /> Monitoring Well ft. <br /> Other ft. <br /> LJ. Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[] NO[ ] <br /> 15. Indicate the responsible party to be billed for additional PIIS•LI1D staff time expended beyond 3 hour minimum <br /> permit payment per tank. IC the party designated below is JiRerenLlban thC.perm_t upli._cant, e.g. property owner, <br /> the party must acknowledge this responsibility for <br /> the billing by signature and date below. <br /> Name / Gilclfli/fLL.f / 8 N • LEtr �SSOe . <br /> Mailing Address 3 7 /Y• Mc-ba 4flELL <br /> i <br /> Day Phone Number ( 70 7 0,O <br /> Sigr�re Date <br /> Page 6 <br />