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ADDRESS r�y�.l�/y f KJ —PA# `;;-, {1 <br /> APN �j ' ' SU# <br /> PERC TEST PARCEL Pere DEPTH PERC RATE <br /> DATE OR LOT# Hole# (feet) (min/inch) COMMENTS(PASS/FAIL) <br /> DATE SAMPLED TYPE OF WELL NITRATE mg/L DBCP ug/L EDB ug/L COMMENTS(other address for well sampled) <br /> —�— v _ <br /> ' r ! <br /> NITRATE LOADING <br /> RESULT(mg/L-N) ' ' SR#: SR� ( _SR Date: <br />