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SR0079971 12 WEST LORENZEN RD,TRACY <br /> oP•qu(y <br /> _ •so AN OAQUIN COUNTY <br /> I z• ^" ENVIRONMENTAL HEALTH DEPARTMENT <br /> w: <br /> ` 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> _ Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: 2 <br /> OWNER NAME: _ _ <br /> CITY: <br /> API: - <br /> _ DATE: ZZ Q2 <br /> APPLICATION#: DEPTH TO FIRST WATER: <br /> SOIL TYPE Ft <br /> REMARKS: <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> i <br /> F <br /> 1 I a 11 1 �! I — - -- - — -- <br /> —I— — .- <br /> L I � .. <br /> • _ I i <br /> l 777 IST I- �-� _1- T i :i i 1-i- <br /> - - - <br /> - - - — - -- _ <br /> i� J�ll I� 1I IfJ1 ! I <br /> I <br /> SOIL PROFILE(IF REQUIRED) SM= S/1- 5An! <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type I Depth Soil T e <br /> 0— - <br /> oU_ �c - <br /> Test Hole#1 Test Hole#2 <br /> Parcel. / Diameter: -4_5 in Depth: in Parcel: Diameter: in De the in <br /> h TIME READING WATER DROP REFILLED _ TAME READING WATER DROP REFILLED <br /> 40:gqo 3.38' Z o'' <br /> gyp. zo <br /> 2-0 <br /> Z. <br /> 2 !23� -ol. <br /> ERCOLATION RATE: �.-T 7 min/in PERCOLATION RATE: min/in <br /> RECOMMENDED SEPTIC EA: g*�: "E"2r'7 RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: Phone:Ao 1-4rz 1�r i Date T� /B <br /> T �L�� <br /> EST CERTIFIED BY: Phone: Date <br /> BSERVED BY(RENS): Phone I! O <br /> IFHD 41-03 REV 11/2/09 U `L-' E O F O <br />