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P4�,y SAN JOAQUIN COUNTY <br /> �--�-�-��•'•�� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 0: 500 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-038 Web:www.sjgov.org/ehd <br /> A�7F�Rr1� <br /> --'� PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: 2-1 (p 00 /V ' DSV I S P­7• CITY: I—OD I <br /> 61OWNERNAME: <br /> APN: c1 - 0,fD'143 APPLICATION#: PPT - gOUO9 3 ( Sf) DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: <br /> REMARKS: R6640u49 f� #-3 <br /> LOCATION OF TEST HOLES{SHOW WELLS AND STRUCTURES} <br /> ........... <br /> S ' .... <br /> PERCOLATION TEST SKETCH _ I� _I I I ' PERCOLATION TEST SKETCH <br /> 2-INDIA.PVC PIPFJ2-IN DIA.PVC PIPE/ <br /> 9, <br /> 4-IN DIA.SOIL BOA G 4-INDIA.SOIL BORING <br /> ir <br /> �� �..........k.. .. - <br /> iI a L_.... <br /> ,..... . _ja- <br /> REFILL HEIGHT ...._ _ RELL HEIGHT..� <br /> -�,....., <br /> : <br /> SOIL PROFILE IF REQUIRED <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> Test Hole#1Test Hole# 2 <br /> Parcel: / Diameter: a " in I Depth: 3 Parcel: Diameter: in I Depth: <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP RE=ILLED <br /> DD F)M 3, K§ <br /> 3. a <br /> /•3u a . 3 . <br /> / 4& 4,11 <br /> PERCOLATION RATE: ��`�____min/in PERCOLATION RATE: ___—_—__— minlin <br /> RECOMMENDED SEPTIC AREA:__ _ _ _ RECOMMENDED SEPTIC AREA: <br /> OFEST PERFORMED BY: f +_ 1� �—_— Phone: _ 1�65—3aWDateal <br /> TEST CERTIFIED BY: Phone: _ 329=D 19�___ Date Ct-- -1 <br /> OBSERVED BY (RENS): _ _ Phone__ T'Z3_ Date <br /> EHD 42-03 REV 1112109 PERC YST RATE FORM <br />