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ADDRESS OR LOCATION <br /> OWNER <br /> APPLICATION N0. L,,,�I-e-qZ - ?? DATE -Z f _Z s/ <br /> '57Z SOIL PROFILE' <br /> ROFILE <br /> DEPTH TO FIRST WATER : ( IF REQUIRED) <br /> _ SIZE OF BORING : <br /> SOIL TYPE: D /s' C/'o S -�/�� <br /> yd Lvc 1 r i� ��•r�p/riTio.7 <br /> REMARKS :.SOa �/�-i.� s�h�a/�- �' �r �v���� e 2 • ?�_ _, <br /> /ou e-,a S i G <br /> LOCATION OF TES HOLES (SHOW WELLS & STRUCTURES) 3 ' <br /> s ' lz <br /> AUG 0 5 1992 $ • <br /> ENVIRONMENTAL HEALTH 9 ' <br /> PERMIt/btMvicro <br /> 10 • S <br /> _ osr v <br /> TEST HOLE 1t 1 TEST HOLE 1.-2 "' e <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> d <br /> r 00 2 z• Z �2 •, <br /> Z <br /> ave 3/ 2S�� <br /> PERCOLATION RATE : 4� ,1�2 L PERCOLATION RATE : _ <br /> RECOMMENDED SEPTIC AREA : RECOMME11DED SEPTIC AREA : <br /> TEST rERF0R11ED BY : �P <br /> TEST CERTIFIED BY : <br /> OBSERVED BY ( SANITARIAt0 - <br /> E!i 05 11 <br />