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Y <br /> V <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> j 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> • �jFOiR,��4 <br /> PERCOLATION TEST RATE �n <br /> ADDRESS OR LOCATION: I t b' I CITY: �' v)a-41 -� C_ <br /> OWNER NAME: r V' ! DATE: — - <br /> APN: Z P_;) b'__� j0 L APPLICATION#: ��UCR��7 � DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: <br /> REMARKS: <br /> i v LOCATION,QF TEST HOLES SHOW WELLS AND STRUCTURES <br /> T-0 <br /> 4 <br /> I 17PHT11]] IT Fn IF <br /> TT <br /> C{ C <br /> - <br /> /T <br /> FT <br /> K <br /> t <br /> VV�uV�� r <br /> i <br /> SOIL PROFILE IF REQ IRED <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> Test Hoe# 1 j Test Hole#2 <br /> Parcel- Diameter: in I Depth: in Parcel: Diameter: in I Depth: :]]n <br /> TIME READING WATER DROP REFILLED TIME I READING i WATER DROP REFILLED <br /> �,.q) an _21, L' <br /> ',//�/ E <br /> 5 <br /> L- <br /> -'t_.__. --__------T__ _._... <br /> z w t _ -- -- --- - <br /> PERCOLATION RATE: 22. t _T min/in PERCOLATION RATE: min/in <br /> RECOMMENDED SEPTIC AR A: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: 7&11'L&I A WA", Phone: Date <br /> TEST CERTIFIED BY: _ Phone: Date <br /> OBSERVED BY (RENS): T R6) Phone Date _ <br /> EHD 42-03 REV 1112109 Z I 1 �6 PERC TEST RATE FORM <br />