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Raul SAN JOAQUIN COUNTY <br /> o:• " a <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> j Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> rtpo <br /> PERCOLATION TEST RATE Q <br /> ADDRESS OR LOCATION: • collie'✓ red . CITY: <br /> OWNERNAME: .Sar, Ca.�•,�a- "I- cv( �Y DATE: <br /> APN: ®O S - /14(o-01 APPLICATION#: DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: <br /> REMARKS: <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> PERCOLATION TEST SKETCH ' ` -'-" _ <br /> I L I I ! PERCOLATION TEST SKETCH I <br /> 2-INDIA.PVC PIPE/ ' °- " 2-IN DIA.PVC PIPE/ <br /> E I I # 4-IN DIA.SOIL BORING <br /> 4-IN DIA.SOIL BORING <br /> . . <br /> i <br /> - <br /> - I ....(..... T- <br /> J..........[.... _ <br /> { � REFILL HEIGHT <br /> REFILL HEIGHT _ - - <br /> _. <br /> a <br /> • fl <br /> SOIL PROFILE IF REQUIRED <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> E <br /> Test Hole#1 Test Hole# 2 <br /> Parcel: 4p Diameter: in IDepth: Diameter: in I Depth: <br /> TIME READING WATER DROPREFILLED TIME READING WATER DROP REFILLED <br /> 30 •3� 3.ss' <br /> '3.,4 O <br /> 3 .Lfo <br /> . 3a 3. 11 p.z 1 3 . 3 5' <br /> 2: � 3. 5Z b-► �- 3-�Z <br /> 2 �3c7 3. S�' O .z3 .off <br /> 3 .3o <br /> 3•. 5-(e b•zCe <br /> PERCOLATION RATE: ___ '2 4------minlin PERCOLATION RATE: _�__---minlin <br /> RECOMMENDED SEPTIC ARE _ RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY. —______—_- Phone: _? _3 to k Z Date _`i`'�a=� _—_— <br /> TEST CERTIFIED BY: _ �_ _ _ Phone: _7e4= 32-9_0/-i8 Date7- <br /> . or, --- <br /> OBSERVED BY (REH / �'—/y- Phone e)a 2% � .3 Date -l✓-r <br /> PERC TEST RATE FORM <br /> EHO 42-03REV1112/09 <br />