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ADDRESS OR LOCATION TJ) �. i r M <br /> OWNER tr f / " I <br /> APPLICATION N0. ..m ^ O DATE_ g - /-� - / J SOIL PROFILE <br /> DEPTH TO FIRST WATER: O SIZE OF BORING : b ( IF REQUIRED) <br /> SOIL TYPE : <br /> y oGrn <br /> 2 ' <br /> REMARKS: <br /> LOCATION OF TEST HOLES (SHOW WELLS & STRUCTURES) 3 ' <br /> Lo 1' <br /> 6, 5 <br /> 6 ' <br /> 7 ' <br /> 8 ' <br /> 9 ' <br /> 10 ' <br /> TEST HOLE #Q 3 TEST HOLE #.71 <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> 0 7 d, - <br /> %� y7 7 2 <br /> Z2 <br /> q ' DS <br /> 4_31v <br /> PERCOLATION <br /> PERCOLATION RATE: (o.7 m;,, PERCOLATION RATE: <br /> RECOMMENDED SEPTIC AREA: ,� nRECOMMENDED SEPTIC AREA: <br /> 'EST PERFORMED BY : St eve l�' ►�n- F//,5, <br /> TEST CERTIFIED BY : <br /> OBSERVED BY (SANITARIAN) <br /> rij nr <br />