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0 p 0 cn <br /> _ °; m <br /> v' O--I fD D <br /> Iz <br /> CL <br /> O 4t N <br /> rn N In <br /> a a�rAtl'Iry - i, : °'�� C 00 <br /> 00 <br /> m ry <br /> - AN.J6A:dUIN COUNTY o <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> - 600 East Main Street,Stockton,CA 95202-3029 p <br /> {r; t slap no:(209!1468-3420 Fax:(209)464-0138 Web:www.sjgovorglehd 3 <br /> PERCOLATION TEST RATE <br /> 3 <br /> e <br /> ADDRESS OR LOC r+ Q <br /> N <br /> ADDRESS <br /> A R ✓TIDNj: - I j . PALM DLII S T AVE. CITY: -rm- <br /> � <br /> = APN: L'4,f-0 L)t l A►'rYl E 2 DATE: r(D D <br /> (D SOIL TYPE APPLICATION K: DEPTH TO FIRST WATER: '* N <br /> fy <br /> REMARKS: <br /> -s <br /> N tv <br /> rD <br /> rD <br /> LOCATION OF TEST HOLES SHOW WELLS AND STRUCTURES) <br /> PERCOLATION TEST SKETCH — PERCOLATION TEST SKETCH <br /> 2-IN DIA.PV'C PIPE __- 2-1NDIA.PVC PD°6' <br /> 4-IN DIA.SOIL BORING L4-IN DIA.SOIL BORING <br /> .. <br /> REFILL 1-1EIv}rP RI]'II.L FIEIGHT <br /> SOIL PROFILE IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> r <br /> Test Hole#1 r— Test Hole#2 <br /> >r Parcel: / Diameter: in 1 Depth: 3 tA Parcel: I Diameter: in Depth: <br /> i, <br /> Tiv- READNG WAT_R DRou J'REF ILL ED Tm- IAIATen DaoF REFILLEI, <br /> 0 <br /> i0 3t' p <br /> /1.66 5 3.7o <br /> 11;.36 r7 L 3,c; <br /> 10_06 ,3° - �•� <br /> 30 kS , 5 I 4.0-7 <br /> oa y( 3q 3. • <br /> 3a 4.3 J'3 3•`9S 1 <br /> PERCOLATION RAT ` ' min/in PERCOLATION RATE: minlin <br /> RECOMMENDED S ARIA:-_ RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED, Phone: 9 ¢05 �Su_ Date <br /> TEST CERTIFIEO•B _ <br /> _ --- Phone: .-- ---------- Date ----- -- <br /> OBSERVED BY(RENS): Phone _ Date <br /> ---- <br /> L14D 42-03 REV 1112109 PERC TEST RATE Form n <br /> n <br /> O <br /> CL <br /> v O <br /> O <br /> O <br /> O _. <br />