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SR0080329
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0080329
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Entry Properties
Last modified
4/11/2019 1:09:22 PM
Creation date
4/11/2019 12:12:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0080329
PE
4222
STREET_NUMBER
16895
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
20914007
ENTERED_DATE
3/13/2019 12:00:00 AM
SITE_LOCATION
16895 W GRANT LINE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
DAfonskaia
Tags
EHD - Public
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Site Address: 16895 W. GRANT LINE RD Record ID SR0080329 <br /> Date: 3/18/2019 <br /> PERCOLATION TEST RATE <br /> (-,q.Ar.j•f Lit-JE P—D. CITIe <br /> ADDRESS OR LOCATIONC ���� l� DATE: <br /> OWNER NAME A3A14 K001 1) DEPTH TO FIRST WATER:_—Ft <br /> APN: 2--n— /-�O— D q APPLICATION# <br /> SOIL TYPE <br /> REMARKS. <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) — <br /> I iZCOL,AI'ION TEST SKETCH PERCOLATION TEST SKETCH <br /> 2-LN DL4.PVC PIPE' 1 <br /> 1•%'C PIPE' I I 4-IN DIA.SOIL BORING <br /> 4-f:PI SII,BORING li-�II <br /> r.7 <br /> 1.1.1.11.1.I,I.klln <br /> KI Ill I III 1(;IFF <br /> SOIL PROFILE(IF REQUIRED) <br /> Depth Soil Type Depth Soll T pe Depth Soil Type Depih Soll Type Depth Soil Type <br /> Test Hole#1 Test Hole#2 <br /> h( Depth. <br /> Parcel: Diameter: in Depth: <br /> Parcel: Diameter: <br /> READ-NG vv., .rn,-- REFILL-., Trt•i- READING 'Pln7rr,Dr:c•,: R`-i <br /> Tr.:= <br /> .14 <br /> 13 S J 3Q <br /> 3Z� 91 <br /> / iUir Vii.� I , "8 • '7 <br /> 3 3 <br /> PERCOLATION RATE: —_fib-------minlin PERCOLATION RATE:_—__ _ — mill <br /> RECOMMENDED SEPTIC AREA: —__—_— RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: -_i c"V «�----- Phone: __'r G�: )L SG Date 6 <br /> —_---_ <br /> _ TEST CERTIFPhone: Date <br /> IED BY: ___ <br /> OBSERVED BY(RE HS�: —LL -- Phone?G`ekQc�ZV�1 Date /Cl)Q <br /> EHD 42-03 REV 112109 PERC LEST RATE FORM <br /> Naseem Ahmed, Registered Environmental Health Specialist Page 1 of 1 <br />
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