Laserfiche WebLink
What is the depth to groundwater' t��) /C �f <br /> =�. �-- c G <br /> Describe the squ qQe of information: <br /> f�F' JJ,/p /r CE <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [ ] NO [ ] <br /> TYPE OF WI=LLS DISTANCE TO TANKS(S) <br /> Public Well ft. <br /> Private Well ft. <br /> Irrigation Well ft. <br /> Monitoring Well ft. <br /> Other <br /> 14. 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-EIID 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 ���� ( -"K-- � PA.1 � '- (�.�.� Vtcc_ l�FW1(Cl�� <br /> Mailing AddresssLA) -FA0 e{ , <br /> Day Phone Number <br /> J ® / <br /> $i Olure Date <br /> Page 6 <br />