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ADDRESS ��`/ S- lI°lyt Adc", (fes PA# / _,-, _J c f <br /> APN C3 5 – ) 50 1\ 13 SU# <br /> PERC TEST PARCEL Perc DEPTH PERC RATE <br /> DATE OR <br /> II LOT# Hole# (feet) (min/inch) COMMENTS(PASS/FAIL) <br /> 2,/, 2- /1. I &6 <br /> L I ZiL 2 Z 7L � 1SJ• 1 <br /> 2- <br /> DATE SAMPLED TYPE OF WELL NITRATE mg/L DBCP ug/L EDB ug/L COMMENTS(other address for well sampled) <br /> NITRA NG <br /> RE (m N) SR#: SR (fie? p �D j,� SR Date: -2-/// / <br />