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.ADDRESS OR LOCATION:1920-E APN: <br /> OWNEP.: GaSSnef Rg$i nCe .-........ DATE: <br /> APPLICATION :::. DEPTH TO FIRST WATER: ft SOIL TYPE: <br /> REMARKS: Parcel f I <br /> LOCATION_ OF TEST FIOLES SHOW WELLS AND STRUCTURES <br /> ji <br /> _ I <br /> SOIL PROFILE (IF REQUIRED) <br /> ( <br /> Depth I Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil T e <br /> TEST HOLE 41 ' DIAMETER; in DEPTH: in . TEST HOLE#2 DIAMETER: in DEPTH: in <br /> W AT LR NV ATE R <br /> CIMS READIIC DROP ZEFILLED T1ME READING DROP REFILLED <br /> C)s xz - <br /> ILI <br /> I .3 7- <br /> ,, <br /> (.Pg 3 ( Z f .0 3 <br /> fo VS 21 . '72 z9 21 . 8 <br /> r D'3s -21 . (041 Z ( • sL7 <br /> r� : os Zi .-77- <br /> i I ! .3S <br /> -7Zrr ' 3s ZI • (o(p . �8 xl 48 <br /> r2 :o5 2i . ? 1 23 <br /> PERCOLATION RAT1C: _ midis PERCOLATION RATE: <br /> RECOMDIENDED SEPTIC AREA: RECONINIENDFD SEPTIC ARBA: <br /> i7c <br /> TEST PFRrF=VED BY: / ..nc: � Ditc <br /> TEST CERTIFIED EY: Calk Phone:_�3 <br /> OBSERVED P.Y .'F ':,: _ Fnetc�—DOS' ri�F'yy� r 7 �y� <br /> i <br /> EHD 41.02-0c, r�-2�� U <br /> REv63D S.!/iD C �i {/ /�. �� ''Ec-MTE FOFMi❑ I <br />