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e <br /> a r. <br /> PERCOLATION TEST <br /> OWNM �I• ADDRESS OR LOCATION: <br /> PM.orS.NUMBER: DATE: -4 0I SOM PROFILE <br /> OF REQUIRED) <br /> DEPTII TO FIRST WATER: SIZE OF HOLE: 1' <br /> z' <br /> SOIL TYPE: 3- <br /> 4- <br /> REMARKS: 4.REMARKS: 3 <br /> 6' <br /> 7' <br /> g. <br /> 9' <br /> LOCATION OF TEST HOLES ON PROPERTY lo* <br /> SHOW ANY WELLS AND STRUCTURES <br /> a8 <br /> 136-5 <br /> I <br /> Z.o <br /> �y' I <br /> ties+ SifPe OF Q„;kr�, <br /> ====;d <br /> TEST HOLE #,Y '7 .TEST HOLE#2 <br /> TIME READING WATER WATER REFILLREADING WATER WATER REFILL <br /> DROP' DROP" DROP' DROP" <br /> ZA 9anP .O <br /> �2 35 99 ' I•�9 ' = o , 7.88 <br /> 11=� >.03' <br /> 1: q.7Z •$� S.l� <br /> -D <br /> = <br /> 15, E M PT'f 5A <br /> ssl <br /> PERCOLATION RATE: l. rn i V\/I'NC,�h -- PERCOLATION RAM: <br /> RECONUWENIDED SEWAGE DISPOSAL AREA: RECONVV[ENDED SEWAGE DISPOSAL AREA: <br /> AlTEST PERFORMED BY: TEST CERTIFIED BY: <br />