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ADDRESS I �-ok �<CA PA# �, - o 0 0 s �, <br /> APN �? y- I I c� — 0 a C) �� SU# 3 L/ <br /> PERC TEST PARCEL Perc DEPTH PERC RATE <br /> DATE OR LOT# Hole# (feet) (min/inch) COMMENTS(PASS/FAIL) <br /> DATE SAMPLED TYPE OF WELL NITRATE mg/L DBCP ug/L EDB ug/L COMMENTS(other address for well sampled) <br /> NITRATE LO NG <br /> RESUL g/L-N) SR#: SR SR Date: S/y/� <br />