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12. What is the depth to groundwater 1 <br /> Describe the source of Information: <br /> 13. Are there any water wells on this parcel or adjacent properties? YES [] NOS <br /> TYPE OF WELLS i DISTANCE TO TANKS(S) <br /> Public Well �J <br /> I <br /> Private Well ! <br /> Irrigation Well <br /> Monitoring Well S It <br /> Other <br /> 14. Will the tanks}pending closure be replaced with an aboveground or underground storage tanio)?YES{]MIX <br /> 15. Indicate the responsible party to be billed for additional PH$.FM staff tame expended beyond 3 hour minimum permit payment <br /> per tank, it the party designated below Is different than the permit applicant.e.g.propertq owner,the party must acknowledge <br /> this responsibility for the billing by signature and date below. <br /> Name O 0Z� <br /> Mailing Address <br /> Davy Phone Number( <br /> tea. f <br /> Signa <br /> Tit Date <br /> EH 23 046 (Revised 10/19/98) Page 6 <br />