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V.?PRESS OR LOCATION: — � AsN <br /> NER: 5 Wr V DATE: <br /> I <br /> }L6iFATION #: DEPTH TO FIRST WATER: NIA- <br /> SOIL TYPE: <br /> MARKS: <br /> LOCATION OF TEST HOLES SHOW WELLS AND STRUCTURES <br /> 71 <br /> tiF9 I <br /> I I I _j 11 1 1 1 11 1 <br /> r <br /> j jL PRO FIL ( F REQUIRED) <br /> k ��/� <br /> Oe th Saii Type Depth Sail Type Depth Sail Type . Depth Sail Type Depth SaiiT a <br /> ST HOLE#1 'QIAMETERi in DEPTH: -i in TEST HOLE#2 DIAMETER: in DEPTH: -AD in <br /> .TIhIE READING DROP ti'YATER REFILLED TwF, READING DROP WATER REFILLED <br /> OPT tv <br /> SA <br /> RL- k- <br /> 1100 .1) .. 2— <br /> �Ll 4on i • 0. 10 <br /> PF,RCOLATION RATE: minlin PERCOLATION RATE: minlin <br /> f, ECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> W,ST PERFORMED BY: " Phone: Date <br /> -ST CERTIFIED BY: Phone: Date <br /> r SERVED BY(REHS . ( - r Phone 3 Date r � <br /> r'D 42-01-003 PERC TEST RATE FORNI1, <br /> trecen'rinnn] <br /> -''1 ^7i <br /> t2.•.nE) Yil• U.t.17 � D� <br />