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•DRESS OR LOCATION: SZ© R r Y i <br /> 1NER: V I44ti/n Q-02 f L DATE: b�— <br /> !`�-rATION #: DEPTH TO FIRST WATER: It SOIL TYPE: <br /> .MARKS: <br /> LOCATION OF TEST HOLES SHOW WELLS AND STRUCTURES <br /> )IL PROFILE (IF REQUIRED) s ,a- a/Go{ eve-z4— <br /> De th Soil T e De th Soil T e De th Soil T e Depth Soil T e De th Soil T e <br /> :ST HOLE#1 DIAMETER: �_in DEPTH: — <br /> TEST HOLE#2 DIAMETER: ID DEPTH: 1n <br /> WATER REFILLED <br /> WATER <br /> TIME READING REFILLED TIME READING DROP <br /> DROP <br /> y= 03 z1/- V2— Z f . 7:?- 3 <br /> 2,I-- o <br /> 10 ; 3 21 • X17 D_ D °7 <br /> a2 • DS D . 1L <br /> z--z - <br /> If = �3 <br /> zz - z5 D _ D �t � <br /> iZ =U3 z_Z - 3 3 U , O81 <br /> — <br /> 3 6 x mini <br /> PERCOLATION <br /> PERCOLATION RATE: /N Gd min/in PERCOLATION RATE: <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> • Phone: <br /> J Y-1 3 Date <br /> ST PERFORMED BY: <br /> Phone: Dale <br /> TEST CERTIFIED BY: <br /> f' Phone Dale <br /> OBSERVED BY( 7/�4p FERC TEST RATE FOR <br /> EIID 42-01-003 <br /> REVISED 57/2002 <br />