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ADDRE-6S OR LOCATION ' 41F- <br /> OWNER l� rYLdfS �✓IW-7 z- 5 <br /> APPLICATION NO . DATE 3/z /2 SOIL PROFILE <br /> C ( IF kEWUIkED) <br /> DEPTH TO FIRST WATER : SIZE OF BORING : <br /> 1 " <br /> SOIL TYPE : <br /> L " <br /> REMARKS : <br /> LOCATION OF TEST HOLES (SHOW WELLS & STRUCTURES) 3 " <br /> 4" <br /> J <br /> 6 " <br /> 7 " <br /> a ► '� � s <br /> iS 10 " <br /> TEST HOLE W3 � � TEST HOLE #2 <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> CO <br /> -- <br /> IC". Cq Is 5`i <br /> 0 3, I q <br /> Il : oq !S 33 5 � �� 7- <br /> ( -Z, oq I� lie <br /> iLf fA-// <br /> PERCOLATION RATE : PERCOLATION RATE : <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA : <br /> TEST PERFORMED BY : k&�2 p 2toT: T,,J14 S��L <br /> TEST CERTIFIED BY <br /> OBSERVED BY (SANITARIAN) O S <br /> cu n. ii <br />