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SAN JoA tJNjY EN1 <br /> ENVIRONMENTAL HEALTH CA <br /> o�or9)ehd <br /> 600 East Main Street,Stockton, sl9 <br /> hone: 209 468-3420 Fax:(209)464-0138 Web:W <br /> .rte. Telep t ) <br /> PERCOLATION TEST RATE '•- <br /> _CITY: <br /> 5 OR LOCATION: / � DATE:�- NrATER' <br /> ADORES A 6 ,,soS60 --------- -— DEPTH TO FIRST �. <br /> ____--- OSS --Z�o��NAME: <br /> O�YNER N APPLICATION <br /> SOIL TYPE: -- <br /> REMARKS: -- <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> SOIL PROFILE(IF REQUIRED) <br /> Soil T e De th Soil T e De th Soil T e <br /> Depth Soil T e De th Soil T e De th <br /> Test HoTest Hole#2 <br /> le# 1 <br /> Parcel: I Diameter: 6 . <br /> o in Depth: ;n Parcel Diameter: in Depth- in <br /> TaE REAADIINNGC WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> o O 0 <br /> 0 6.v 6-0> - ---- -- <br /> a ------ <br /> c:> <br /> 0o0 t2 b — --- - --- — <br /> 'Fq_A5))LATION RATE: � minlln PERCOLATION RATE: minlin <br /> �FRr5i,AMENDED SEPTIC AREA: _ RECOMMENDED SEPTIC AREA: <br /> �ERFORMED BY: ,E.s+��� Phono: Dote <br /> -_�ERTIRED BY: Phone: _ - -- gate -- <br /> )B';ERVED BY(RENS)' _ ���. _ Phone J � _._`=. ��L_ Date� <br />