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° <br />DEPARTMENT <br />kton, CA 195202-3029 <br />WrNVI80NM org/ehd <br />600 East main Fax:(209)Ai a -o 138 Web: Ww <br />-34 <br />T,4,pwne. .(209) 468 34 TION TEST RATE <br />PEFZCOLA <br />p- 0 - <br />ADORM OR LOCATION: <br />OWNER MAW ApPUCATION 0: <br />SOIL ly;,E <br />ROWKS: <br />OF <br />' ---� TEST SKETCH <br />z-INnIA-'VC PIPE/ <br />4- NmMSOIL BORING <br />' <br />/o' <br />l» --- <br />1 F <br />� <br />i WILL HEIGHT 3 13 <br />w.' _----- <br />ox/E <br />_ DEPTH ronnor,vxrsn <br />STRUCTURES) <br />FIOLES (SHOW WELLS AND r'piiCOLATION TEST SKETCH <br />4- IN DIA. SoEL BORINC, <br />,TH4 /�- I- <br />oBaFRvEDu'�- -' ------- <br />uw*n^w,�s��, <br />Phone: 1%, AREA- -------_mwin/n <br />Phone: <br />�----�-�����- Deoe <br />----- ---+�=f <br />phoou Dote _ -~------_—� <br />___--- Date <br />° <br />