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ADDRESS OR LOCATION' <br />OWNER NAME: P <br />APN: <br />SOIL TYPE: <br />REMARKS: <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />SOIL PROFILE (IF REOUIRFnI <br />PERCOLATION TEST RATE <br />APPLICATION #: <br />2 <br />CITY: _ �ir-Q cy <br />PATE: L <br />DEPTH TO FIRST WATER: Ft <br />1 wiv vr- I cJ I nvL.C.7 tJMUVV WtLL5 AND STRUCTURE <br />Test H 1e # 1 <br />Parcel;Diameter: ta in I Depth: Ain <br />'ERCOLATION RATE: 1 ¢, l� min/in <br />ZECOMMENDED SEPTIC AREA: <br />-EST PERFORMED BY: VP� Ev'c ALr <br />"EST CERTIFIED BY: <br />)BSERVED BY (REHS): <br />HD 42-03 <br />'9/04 <br />Test Hole # 2 <br />Parcel: Diameter: in I De the in <br />TIME READING WATER DROP REFILLED <br />PERCOLATION RATE: min/in <br />RECOMMENDED SEPTIC AREA: <br />Phone: Z11 Date <br />Phone: _Date <br />Phone d3 S,5 Date ,�-3 <br />PERC TEST RATE FORM <br />Co? <br />