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12. What Is the depth to groundwater? V <br /> De Gripe the source flnforQt tion: <br /> wtes e . �°rxwat hep fiv ivu lJ�ils — 1� ' ' t`� 1ti83 <br /> 13. Are there any water wells on this parcel or adjacent properties? YES j J N6*fl <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public Well fL <br /> Private Well fL <br /> Irrigation Well tL <br /> Monitoring Well ft. <br /> Other fL <br /> 14. Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ j NO[ j <br /> is. Indicate the responsible party to be billed for additional PHS-EHD staff thne 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 billing by signature and data below. <br /> Name ZP D 71 N <br /> Mailing Address e ml "IJ to Vu � �I/( f3Yl f�j �C7 lIS� 7i s�7 <br /> Day Phone Number (/ <br /> Signa— e D <br /> EH 23 046 (Revised 10/ 19/98) Page 6 <br />