Laserfiche WebLink
12. What is the depth to groundwater? (Q{� IDCIJ�1 7�+ <br /> Describe the source of information: <br /> ^U <br /> ! -I <br /> 13. Are there any water wells on this parcel or adjacent properties? YES W'NO[] <br /> I <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public Well ft 71 <br /> Private Well 1 `C:. fL <br /> i <br /> Irrigation Well rL f <br /> Monitoring Well IL <br /> i <br /> Other fL <br /> 14. Will the tank(s)pending closure be replaced with an aboveground or underground storage tank(s)?YES1. 10(] <br /> 15. Indicate the responsible party to be billed for additional PSS-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,he party must acknowledge <br /> this responsibility for the billing by signature and data below. <br /> Name i 6or(r Tr m U1iP S <br /> Mailing Address <br /> Day Phone Number <br /> Signature ltie Date <br /> EH 23 046 (Revised 10/19/98) Page 6 <br />