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l1LLL rLfCI.ULti11V11 1La11fYV r•.r�ni <br /> Owner: Date: pq�/700 <br /> Address or Location: <br /> 5'TOC KTOL( /fk <br /> Hole size (Dia. ) : f?'?r PIr Depth to Groundwater: ^ �r <br /> P.M. or S. Number: Soil Type: �1� DLiCL'ML}MLS 5M <br /> Remarks: SOIL PROFILE <br /> (IF REQUIRED) <br /> 1' H o <br /> 2 ' <br /> LOCATION OF TEST HOLES ON PROPERTY rWfop <br /> (Show any wells & structures) 3 ' PH LoE{ <br /> 4 ' <br /> CL- <br /> S�� 5 r rG PI-A 5 ' P-H <br /> 6 '7 ' <br /> 8 ' <br /> 9 ' ML-IAP <br /> A� MLHEI <br /> LrnLS <br /> CL L M <br /> 21 CL ML 5M <br /> TEST NOTE N: 4 DEPTH: F 7- TEST HOLE t: DEPTH: <br /> TINE READING WATER DROP (IN) REFILLED TIME READING WATER DROP (IN) REFILLED <br /> 9:00 17 — 2: 00 /6. <br /> 9 s 46 <br /> /0 00 7. G 7 ' /. 3 " <br /> 103 /777 ' / 2" <br /> Od /7. <br /> zp E- GicV <br /> 2:00 / 3 J <br /> /, 3 " <br /> '(0/r <br /> PERCOLATION RATE (MINUTES PER INCH): PERCOLATION RATE (HIRUTES PER INCH): ;77 -3 llliAtll <br /> RECOMMENDED SEWAGE DISPOSAL AREA (SQ. FM) RECOMMENDED SEWAGE DISPOSAL,-AREA (SQ. T) t <br /> TEST(S) PERFORMED BY: TEST CERTIFIED BY: <br /> OBSERVED BY (SANITARIAN): uU (R.E. OR R.S. NO.: <br />