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13. What is the depth to groundwater? <br />Describe the source of information: <br />5AfJ 1o,A0 `1-J C.O, G0-0<NOw?"�tF� Q-dC-'2.'T. <br />13. Are there any water wells on this parcel or adjacent properties? YES (J NO <br />TYPE OF WELLS <br />DISTANCE TO TANKS(S) <br />Public Well <br />ft. <br />Private Well <br />ft <br />Irrigation Well <br />ft <br />Monitoring Well <br />ft <br />Other <br />ft <br />14. Will the tank(s) pending closure be replaced with an aboveground o nndergroand torage tank(s)? YESYQ NO( J <br />15. Indicate the responsible party to be billed for additional PHS-EHD 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 <br />owner, the party must acknowledge this responsibility for the billing by signature and date below. <br />Name <br />Mailing Address <br />Day Phone Number ( Zc�-1 ) 3 -5 4- —31- 33 <br />Signature • Title <br />EH 23 046 (Revised 7/10/96) Page 6 <br />Date <br />/- 30- IF <br />