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IRA <br /> ENVIF2 MENTvµ�Vlryk" N19 <br /> ADD Qn Q�ephoAe6f20o 66--?q2OSE°kt H UF_PAI'<l h1F_PJr <br /> ADDRESS OR LOCATION: ax:r2pc,' IG4-o1-3 w UL-3i�ly <br /> OwNERN.AME _ t,Jr RATE <br /> PERCOLATION TEST W81aov,rg)eha <br /> APN: w-,r- - '� <br /> SOIL '�J�.'• _yl - ' <br /> TYPE. Lrt iY) �.t—� <br /> clTv <br /> REMARKS: APpOCATroN K: Dn <br /> rE <br /> — DEPTH`TO FIRSTWATER <br /> LT _- ., <br /> ATION OF TEST HOLES(sllow wELLs <br /> PERCOLgrION hPS AND STRUCTURES) <br /> SKETCH <br /> nLa s,-,1f 7TL RERC'OLATI^ . <br /> Si^xr�c ON TES- <br /> T SKEI C H <br /> I <br /> -IF DIA.P\'r pD,p <br /> / ) — _ a-1\DI:\.1,4&JkIX,; <br /> 3 <br /> I Iurul Inn;In �_ <br /> REQUIRED) <br /> t Ype D Soil Type Depth Soil T pe Depth i Soil Type Depth Soil T e <br /> i <br /> Test Hole it 1 <br /> ter: in Depth: 3, tTest Hole#2 <br /> Parcel: Diameter n Depth. <br /> To- <br /> 3, <br /> '- <br /> 3, 5) <br /> 37q t2 3 !$ <br /> 3. 7 r <br /> TION RATE: LJ 0 __minlin PERCOLATION RATE: _______--minlin <br /> MENDED SEPTIC AREA: ___ RECOMMENDED SEPTIC AREA: _ <br /> ERFORMED BY: 1F��c= --------- Phone: 1 `_ _a Date _f i 11`.---- <br /> ES RTIFIED BY: - - Phone: -- --- ------ Date ----- - ------- - <br /> =E. D BY(RENS): _ _ __--_—__—_ Phone_______—_—_ Date <br /> — PLRC TEST RAIL f ORM <br /> U�§Uno §2 no <br /> IS <br />