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ADDRESS OR LOCATION G 5 �/o /� u sf�� G4d <br /> 0pr r <br /> OWNER /d S / 2 v r � -�/ G o� <br /> APPLICATJON NO - DATE SOIL PROFILE <br /> ,r ( IF ;rREQUIRED) <br /> DEPTH TO FIRST WATER : SIZE. OF BORING : <br /> � <br /> SOIL TYPE: <br /> REMARKS : <br /> LOCATION OF TEST HOLES (SHOW WELLS & STRUCTURES) 3 ' <br /> w <br /> 4 ' <br /> 0 <br /> t, ;4 <br /> 7 ' lig <br /> � I <br /> TEST HOLE 11 TEST HOLE 12 <br /> ,M <br /> TIME READING WATER DROP REFILLED TIME READING WAFER DROP REFILLEDI <br /> 9 z it <br /> Zg,4II r - <br /> ,�� z <br /> l <br /> PERCOLATION RATE : PERCOLATION RATE: <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA': <br /> TEST PERFORMED BY : f1"7 5 . y' <br /> TEST CERTIFIED BY : l a� <br /> 6+:�"i ONGC <br /> U�illry�� <br /> OBSERVED BY (SANITARIAN) TNOV � <br /> EH 06 11 <br />