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0312MAR�26 '98, 01:16-P-M RMS STAR Nk2 INC SEMC® P.2E 02 <br /> t®, What is the depth to.eraubdantsr? <br /> Dateribe the scarce of ialbrm u <br /> 13. Are there any water welts on this patcei or adjacent properties? YES C 1 Yo I <br /> TM OF WE= DWANCE TO TAMLSM <br /> Public Well tt, <br /> to Weil IL <br /> tion Weil fL <br /> Monitoring wei tt. <br /> Other fL <br /> 14. Will the k(s) peadieg clasmv he repheed with an abovWoouo or madorrvamid storage tank(s)? YES! I lo , <br /> 1S. India" dwrimporwok parry to be billed for additional PIIS-BHD sssfF time expended beyond 3 dour minimum <br /> permit payment per task It the paety dei ted blow is d1fremt then the permit applicant, e.g. propem <br /> owner, the PaM mart adutowkdge this rsapoOaibility for the billing by signature and date below. <br /> Name Loeles-Lx- <br /> Mailing Add )C Z`-a T I��S a✓1 C A 94 <br /> D <br /> at lYut$bnr r V z� U <br /> T)tte Date <br /> EN 23 !111!96) Page 6. <br />