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P�IZGEL 'N4 I PN: 0C � :0r - 9 <br /> ADDRESS OR LOCATION: 1 <br /> _ „ ( DATQ9 jZ Z <br /> OWNER: 2r a <br /> T <br /> ON #: <br /> ,, D>=PTH 70 FIRST WATER: ft" SOIL TYPE: <br /> s'�'"GA <br /> ;OMARKS. <br /> pLl - <br /> Y <br /> ERAS-A40N TEST D�T�.ti L5 fir £` " 1 <br /> W&►oiF WRv-V IRs'P4 Ai rMb 10 F- s1~t #t�- , �g� st [9 IMc qLATtC" <br /> Ww 'A - � - <br /> beep F;c6LftTg),,,4-W_�sr viGuE IsKI WIM DMP -Pv" ' <br /> SOIL PROFILE(IF REQUIRED) <br /> P i <br /> De th Soil Type Depth Soil Type Depth <br /> 'Soil Type Depth Soil T e De th Soil Type' <br /> " <br /> ff-EST MOLE#5PUTAMETER: � -y` in DEPTH: � in TEST HOLE 4W3bm' TER: � In DEPTH:c� 0-A57 <br /> cs <br />} WATER WATER REFILLED <br /> DrYIE READING DROP(w) REFILLED TldlE READING DROP(' <br /> loot, 13.,E .+e.. 04071 <br /> 1.2-0b <br /> E <br /> tl <br /> 1300 0.to <br /> WOO ub <br /> rx I <br /> xd" <br /> PERCOLATION RATE: PR= =.6 � $t�"C <br /> <7t4t "Aminjin PERCOLATION RATE: � �����" i minlin <br /> RECOMMENDED SEPTIC AREA: <br /> RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: .f�,z. G I Phone: Date <br /> ESE CERTIFIED BY: Phone: �'] �' 13 -75— Date <br /> OBSERVED BY(REriS,}: R Phone Date <br /> FERC TEST RATE FORMic <br /> EIID42-01-003 <br /> ' REVISED 5/7/2002 " <br />