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p = p rt <br /> OrD <br /> -4 D <br /> D O o Q <br /> oI <br /> v <br /> LII. � <br /> N <br /> n� '•'P-�c"''•o M N <br /> NJ <br /> M SAN JOAQUIN COUNTY O 'D 00 <br /> �• rr v c <br /> ,,} < ENVIRONMENTAL HEALTH DEPARTMENT rt 7z <br /> _.' •'; 1868 East Hazelton Avenue,Stockton,CA 95205-6232 O O <br /> 4 p• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.orglehd 3 Q <br /> tldaa —I <br /> m PERCOLATION TEST RATE <br /> 'I LaV/U- <br /> '-r ADDRESS OR LOCATION: 2'L�' �fp r,,,,t, CTn: (/1 S = <br /> � O <br /> OWNER NAME: 1-ep "T'',. i if{ DATE: A fD 0 <br /> APN:_�l�1�1) 1(O y APPLICATION M: DEPTH TO FIRST WATER: ` Fl h <br /> ❑l <br /> r-r SOIL TYPE: <br /> ZT <br /> Ln REMARKS: <br /> rD <br /> r) <br /> v LOCAT N OF TEST HOLES(SHOW WELLS AND STRUCTURES) ! { I ( 1 1 t <br /> Ln <br /> I I I I I I 1 i { I I j f LU_LI �I <br /> _ 1 <br /> ' I ! I I I � II I •! ' ! I I If 1 1 <br /> SOIL PROFILE(IF REQUIRED) <br /> Soil T e De th Soil T e De th Soil T e <br /> De th Soil T e Depth Soil T e De th <br /> I <br /> _ Test Hole#2 <br /> — Test Hole#1 Diameter: in De the in <br /> Parcel Diameter* <br /> in Depth' • `r it Parcel: <br /> REFILLED TIME <br /> READING WATER DRW REFILLED <br /> TIME READING WATER DROP 511 p, 75 <br /> R1 I ;Z17 <br /> X17 <br /> 2. <br /> g2.7 <br /> 1LYJ�— 7 <br /> /2 02��'7 Z 2r7 <br /> C <br /> 3 minlin PERCOLATION RATE: <br /> minlin <br /> PERCOLATION RATE: RECOM N ED SEPTIC AREA: <br /> RECOMMENDED SEPTIC EA' Phone: 1 ' Date <br /> TEST PERFORMED BY: Phone: Date /� � <br /> T-- II �( n <br /> CERTIFIED BY: Phone Date l0 0 <br /> TEST ° <br /> OBSERVED BY(RENS): O Qn O D RCTESTRATEFOi A fl <br /> f � <br /> o <br /> (DD "'y I 00 <br /> 0 LO <br />