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12. What is the depth to groundwater? L 1W. 1410 w " <br /> Describe the source of information: <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [] NO[] <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public Well ft. <br /> Private Well ft. <br /> Irrigation Well ft, <br /> Monitoring Well ft. <br /> Other ft. <br /> 14. Will the tank(s)pending closure be replaced with an aboveground or underground storage tanks)?iF -Nq4 Mlle+ . <br /> F'.tST%"CY -V W%LS mz--v_ TMJ F- TZM:r 13<4NED. <br /> 15. Indicate the responsible party to be billed for additional PHS-EHD staff time expended beyond 3 hour minimum permit payment <br /> per tank. If the party designated below Is different than the permit applicant,e.g.property owner,the party must acknowledge <br /> this responsibility for the billtng by signature and date below. <br /> Name TA-r4- tj RECRZ_ CA RMARL GAS 4MD E.c_EC_7rf2IC GDF-RSRM�/ <br /> Mailing Address P. L- <br /> Day Phone Number( 4-A5 1 cm z—'i"T 44 <br /> gnatu a Title Date <br /> EH 23 046 (Revised 08/13199) Page 6 <br />