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• 1 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> X 600 East Main Street, Stockton, CA 95202-3029 <br /> �: "•j Telephone: (209)468-3420 Fax:(209)464-0138 Web:www,sjgov.org/ehd <br /> ° PERCOLATION TEST RATE <br /> <Foy <br /> 2Zz �, . COLLI CR P-4->- CITY: Ac+��Pz) <br /> ADDRESS OR LOCATION: 3 <br /> OWNERNAME: CLdfr LF—"7,1 DATE: <br /> APN: 0f7 S - �- - APPLICATION#: DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: <br /> REMARKS: <br /> LOCATION OF TEST HOLES{SHOW WELLS AND STRUCTURES) <br /> I i l i I PERCOLATION TEST SKETCH s <br /> PERCOLATION TEST SKETCH .�.�..._.,—�- , <br /> _y........._p. .. A 2-IN DIA.PVC PIPE/ <br /> 2-IN DIA.PVC PIPE/ i ; g I 3 £ <br /> ,yy 4—IN DIA.SOIL BORING 4-INDIA.SOIL BORING <br /> , s <br /> 3 c d <br /> i <br /> } <br /> REFILL HEIGHT '— <br /> REFILL HEIGHT - <br /> - .. ,....._ _._y I ..._FLTi' , <br /> SOIL PROFILE IF REQUIRED <br /> D= - <br /> Hole <br /> l Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> Test #1 Test Hole# 2 <br /> karcel: Diameter, in Depth: 7j•� <br /> Parcel: Diameter: in I Depth: <br /> TIME READING WATER DROP REFILLED <br /> TIME READING WATER DROP REFILLED <br /> 12°- rg 3.S o• I � <br /> o •os 3 <br /> o g , '3 n -0-k-0-10 3 - 04 <br /> Z Z <br /> 3 • q-F' 3 ,0--4- b o� <br /> minlin PERCOLATION RATE:_----_----- minitn <br /> PERCOLATION RATE: --_—��•�----__ RECOMMENDED SEPTIC AREA: _----__—__—_-- <br /> RECOMMENDED SEPTIC AR <br /> TEST PERFORMED BY: , � ----------- <br /> Phone: 2oy_3�S_3z2 Z_ Date --- <br /> '-� _ Phone: ryeq -T25=®l of Date <br /> TEST CERTIFIED BY: <br /> Phone — ) G/ Date <br /> OBSERVED BY (REHS� ✓ �% > '�' _ - - '� <br /> PERC TEST RATE FORM <br /> EHD 42-03 REV 1112/09 <br />