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ADDRESS <br /> 2 � 6© C) <br /> APN �° _ Q PA# I GY �C� C9 <br /> PERC TESTPARCEL Perc DEPTH PERC RATE <br /> DATE OR LOT#. Hole# <br /> (feet) (minfinch) COMMENTS <br /> a• <br /> DAT SAMPLED TYPE OF WELL NITRATE mg/L DBCP ug/L EDB ug/L COMMENTS(other ad ress for well sampled) <br /> (Ti , <br /> +0 r uk VL)f AQP <br /> �U n i v\/' <br /> NITRATE LOADING ,�q0 <br /> RESULT(mg/L-N) r � SR#: SR (Vj <br /> SR Date: <br /> • <br />