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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �FQ.. PERCOLATION TEST RATE <br /> ZZ Z �• COLL.I£?Z � CITY: hC-Aw,P0 <br /> ADDRESS OR LOCATION: 3 DATE: � ' ��"� <br /> OWNER NAME: S�-A �ur 7- } CLAfF FIJI <br /> 14(c -o'} APPLICATION#: DEPTH TO FIRST WATER: Ft <br /> APN: Cos- <br /> SOIL TYPE: <br /> REMARKS: <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> PE ' ! i I PERCOLATION TEST SKETCH r <br /> PERCOLATION TEST SKETCH _�......_,_ <br /> _...... 2-R1 DIA.PVC PIPE/ -.......... ....= ._ 2-IN DIA.PVC PIPE/ <br /> 8 <br /> i £ i 4-IN DIA.SOIL BORING <br /> 4-IN DIA.SOIL BORING <br /> ,,�Le- -. _ <br /> - REFILL HEIGHT <br /> . k r;1 <br /> i <br /> ..............i <br /> 7 <br /> SOIL PROFILE IF REQUIRED <br /> Depth Soil Tye Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> Test Hole#1 Test Hole#2 <br /> PPrcel: Diameter: o' in Depth: '3•�-(- Parcel: Diameter: in Depth: <br /> READING WATERDROP REFILLED TIME READING WATER DROP REFILLED <br /> TIMEPq <br /> X2 : 23 , Fr b. zl • �3 <br /> 23 <br /> :5-3 3 • FS'y D . , 3•�b <br /> y : z3 8- 3 <br /> 2 : �3 ,"}9 �•t� 3. x'1 <br /> 3 .. 7-3 <br /> 3 o ( 3- <br /> 3 :5.3 <br /> PERCOLATION RATE: <br /> ! _Z—_____miniin PERCOLATION RATE: _—_--___—__---minlin <br /> --_—�-: <br /> RECOMMENDED SEPTIC AR —__--- RECOMMENDED SEPTIC AREA: _----__—__—_-- <br /> TEST PERFORMED BY: _ �_—___ --- Phone: _?�`t_3&F-3yZZ' Date <br /> Phone: Date <br /> TEST CERTIFIED BY: -- - <br /> OBSERVED BY (REH ? ®,v '_' y - ?--- Phonet [�'�y-'sa Date <br /> PERC TEST RATE FORM <br /> EHD 42-03 REV 1112/09 <br />