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ADDRESS OR LOCATION <br /> OWNER <br /> APPLICATION NO. A7r•9Y- O ! DATE_/O—/7- 9'y <br /> SOIL PROFILE <br /> DEPTH TO FIRST WATER : 24YY SIZE OF BORING: /Z ( IF REQUIRED) <br /> 11 <br /> SOIL TYPE :10 So./, N i�-- �. S.r..,.�Q Gnrvr/ <br /> 2 • a , <br /> REMARKS : <br /> laic <br /> �' zs <br /> LOCATION OF TEST HOLE ( SHOW WELLS & STRUCTURES) 3 ' <br /> 11 <br /> 7 ' 17 <br /> �a <br /> \ 8 ' /Y <br /> 10 ' <br /> 1A. TEST HOLE ;sl TEST HOLE it / <br /> " . TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> 11 3 <br /> :0 78 <br /> / 33 /DD %z zz /z,l <br /> 2: 03 <br /> 3 3 /o /6 �Z / <br /> 3:e /y8 % /Z <br /> 3 : 33 (�/ '/ /Z //z <br /> ./ <br /> PERCOLATION RATE : 25 'A, PERCOLATION RATE : <br /> RECOMMENDED SEPTIC AREA : RECOMMENDED SEPTIC AREA : <br /> TEST PERFORMED BY : <br /> TEST CERTIFIED BY : <br /> OBSERVED BY (SANITARIAN) <br />