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PER OLATION TEST <br /> OWNER: v5w,�e6 ADDRESS OR LOCATION: <br /> P.M. or S. NUMBER: DATE: Q Z o <br /> — SOIL PROFILE <br /> DEPTH TO FIRST WATER: Q A SIZE OF HOLE: <br /> SOIL TYPE: I/1 (F-M) 2, <br /> REMARKS: <br /> 3' <br /> 4' <br /> LOCATION OF TEST HOLES ON PROPERTY 5' <br /> (Show any wells or structures) 6' <br /> 7' <br /> 8. <br /> 9' <br /> 10' <br /> j5Q(ki `p <br /> -43 <br /> Bottom: •3 Fill to: 3• Bottom: Fill to: <br /> PS TEST HOLE #1 TEST HOLE#2 <br /> TIME READING WATER DROP " REFILL TIME READING WATER DROP " REFILL <br /> c 3 '7 <br /> I: a • foo` <br /> 0 os <br /> 0" 5 5 " <br /> 5-0 4. Z3 • 2 8 3 (05 <br /> IZ�ao 4 .0 . 35' <br /> o' Zoe ,® <br /> PERCOLATION RATE: PERCOLATION RATE: <br /> RECOMMENDED SEWAGE DISPOSAL AREA: RECOMMENDED SEWAGE DISPOSAL AREA: <br /> i <br /> TEST PERFORMED BY: '_ ,i D A-�, u o 4. TEST CERTIFIED BY: <br /> OBSERVED BY (ENVIRO. HEALTH): (R.C.E. or R.S. #: <br /> c�, Ion <br /> //0"IIVuTQ5 <br />