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Aay.i y JAN JVAWUIN %-vuly l > <br />z ENVIRONMENTAL HEALTH DEPARTMENT <br />K 600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov orglehd <br />MW <br />PERCOLATION TEST RATE <br />Hh1,S tY�A/.i" r, <br />DRESS OR LOCATION: '1 fJ �� CITY / <br />DATE: i 1 T ATER. <br />4NERNAME �v l W <br />'N: �� _ ` L APPLICATION W <br />DEPTH TO FIRST <br />DIL TYPE <br />EMARKS: <br />LOCATION OF TEST HOLES (sl+ow wElls AND sTRuc <br />1i_ PERCOLATION TEST SKETCH <br />- <br />-t\ DIA. PVC PDT. <br />I)i:\ SOIL BORING <br />7 <br />REFILL HEIGHT <br />SOIL PROFILE (IF REQUIREC <br />nom,+n Soll Type <br />PERCOLATION "EST SKE I <br />REFILLIiEIG <br />IN, DIA. DIA. Pv'C PIPE' <br />3- IN DIA. SOIL BORING <br />n_ <br />e Depth Fsoil Type Depth Soil Type Depth Soil T <br />Test Hole # 1 <br />Parcel. <br />Diameter in Depth: /3• ' <br />P OLATIONRATE: _—��-------minlin <br />RMMENDED SEPTIC AREA:--_--_- <br />TEST PERFORMED BY: <br />/�acc—�---- <br />QT CERTIFIED BY: j- -- --- - <br />_ERVED BY (REHS)' - <br />2-03 RL 1117?YJ9 --- <br />L� <br />Test Hole # 2 <br />Parcel: Diameter: inDepth: =�j <br />rcc'.v'nmc"ur-u )Itl-I IC AREA: R11n1in <br />Phone: Date -- <br />Phone: Date <br />Phone 44 <br />--- - --.� Date <br />►'lftt <br />IISI ItAII I UKhi <br />REr.r t4G <br />K <br />�7 0 <br />�3 <br />ba <br />P OLATIONRATE: _—��-------minlin <br />RMMENDED SEPTIC AREA:--_--_- <br />TEST PERFORMED BY: <br />/�acc—�---- <br />QT CERTIFIED BY: j- -- --- - <br />_ERVED BY (REHS)' - <br />2-03 RL 1117?YJ9 --- <br />L� <br />Test Hole # 2 <br />Parcel: Diameter: inDepth: =�j <br />rcc'.v'nmc"ur-u )Itl-I IC AREA: R11n1in <br />Phone: Date -- <br />Phone: Date <br />Phone 44 <br />--- - --.� Date <br />►'lftt <br />IISI ItAII I UKhi <br />