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k ' . • • <br /> 11 What is the depth to roundwater? <br /> A - To 40 FEET <br /> Describe the source of information: <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [ ] NO [ ] <br /> NONE AT THIS SITE, NOT AWARE OF ANY ON ADJACENT SITES <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 /> OtherIL <br /> ft. <br /> 14. Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ ] NOW <br /> 15. Indicate the responsible party to be billed for additional PIIS-EII1} 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 owner, <br /> the party must acknowledge this responsibility for the billing by signature and date below. <br /> Name CATHERINE R. BEVANDA CATHERINE A. BEVANDA & ;OSE r1'---BEVANDA DBA "", p PERTIE <br /> Mailing Address C/O PETER P, PERSIL PI.J. BEVANDA PROPERTIES <br /> X , NORTHE OLLYWOOD, ALIFORNIA TU <br /> Day Phone Number ( 21.5 } 877 5246 <br /> SEE ATTACHED SERVICE REQUEST (YELLOW FORM) <br /> Signature I?ate <br /> Page 6 <br />