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o o oI -I D <br /> D 000 CL <br /> CL <br /> 0 <br /> N <br /> o� O O <br /> v <br /> A LO F, <br /> O to <br /> rT'I Ln PERCOLATION TEST RATE O <br /> -1 ADDRESS OR LOCATION: / Z <br /> O ---__ CITY: 'J_;'^ <br /> OWNER NAME_ >! �iJ <br /> DATE: -�` •-- `i � O <br /> 4PL APPLICATION JI: DEPTH TO FIRST WATER: Ft H <br /> (D SOIL TYPE <br /> K <br /> REMARh S' VI 06) <br /> O D <br /> 2 rD < <br /> r+ rD <br /> LOCATION OF TEST HOLES SHOW WELLS AND STRUCTURES <br /> L N <br /> rt 1 L- e--t <br /> 73 <br /> rD - - rt <br /> _ _ O <br /> r* I J1 ! <br /> I <br /> rD <br /> '-I 1l -TT- <br /> �I l ii=i 1 i I -: <br /> rD _ n [_- ---I- <br /> ��D r �TT �� <br /> !7-1 I , — .� -I -j rte .II L� <br /> SOIL PROFILE REDumED) <br /> D th Soil T De th Soil T De th Soil T e Soil T De th Soil T e <br /> Test Hole#1 <br /> Parcel: IDiameter: -- Test Hole#2 <br /> 6 in !De the-� in : - -- -- - — <br /> Parcel z--� piameter: i2 in iDepth: <br /> TIME I READINGW�DROP <br /> X1.7 L REFILLED TIME <br /> •�� READING WATER DROP REFILLED <br /> 0 Z Z 75" �. <br /> ji- <br /> 00 1/7' .06' 07' oL' <br /> ILI <br /> • 5 i b~; <br /> Z dot07' <br /> PERCOLATION RATE: 1�1 min/in PERCOLATION RATE: �,I .3 <br /> RECOMMENDED SEPTIC AREA: minhn <br /> TEST PERFORMED BY:_ n/ RECOMMENDED SEPTIC AREA: <br /> TEST CERTIFIED BY: Phone: (2 �331f-,�j6/3 Date <br /> OBSERVED BY(RENS): Phone: Date <br /> END 42-03 REV 11Q0 Phone Date <br /> —7 PERC TEST RATE FORM <br /> rD <br /> n <br /> O <br /> O ; a p o CL <br /> 0 <br /> (D O <br /> O <br /> 00 <br /> O p <br /> N p <br /> N <br />