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SAN JOAQUIN COUNTY <br /> _ ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> i 1 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> /� ��LL LV PERCOLATION TEST RATE /� <br /> ADDRESS OR LOCATION: 00 , A 1 pi m, R G - _ CITY: Cod 1• C,14 <br /> OWNER NAME: t H .ATE:�0 -a —0!2 <br /> APN: (25' 1� 0��— Q,_,& APPLICATION#:�ef7- g Q003Z DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: L)QIrk & [a in-&- 50tw, &of .. t I!p 1 <br /> REMARKS: <br /> LOCATION OF TEST HOLES SHOW WELLS AND STRUCTURES) <br /> _ _ _ _ _ <br /> • _ i c _ - - - - - - - - - <br /> x <br /> 3 <br /> T—F. <br /> 77_1 <br /> � .__i — --1I I. _I I IF —Tii e I i k 1��I II.....i._ _�—. -1 I <br /> —I 1-1 LF1 <br /> SOIL PROFILE IF REQUIRED <br /> De th Soil Type Depth Soil Type Depth Soil Type De th Soil Type Depth Soil 7 e <br /> Test Hole#1 Test Hole#2 <br /> Parcel: Diameter: 4 in Depth, in Parcel: Diameter: in Depth: in <br /> TIME READING WATER DROP REFILLED TIME READkNG WATER DROP REFILLED <br /> 7Y <br /> r� <br /> I <br /> -'s Yej.,ff / <br /> .tax <br /> 1 :00 r' <br /> 1! 6 U <br /> fRCOLATION RATE: _ , TION min/in <br /> ..,dCOMMENDED SEPTIC AR �r� I,;iR5COMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: -r+ ,-.:,�Pha .�, —0 �" Date <br /> TEST CERTIFIED BY: P pie - —03}S Date La 7� <br /> OBSERVED BY Date <br /> EHD 42-03 PERC TEST RATE FORM <br /> 718!04 <br />