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-0 cn <br /> =O (D <br /> OCL <br /> CL <br /> * m <br /> � U) <br /> Cn <br /> aoe.4_u�y- i N <br /> L - - Cn <br /> M <br /> 1868 East Hazelton Avenue,Stockton,CA 95205-6232 n "1l <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:vrww.sigov.orgrehd —i tp <br /> " oa O <br /> PERCOLATION TEST RATE Z 0 <br /> ADDRESS OR LOCATION:. j FA5'T CITY: - cA <br /> OWNER NAME: '4 Atj- 00 <br /> APN. _ :: 4J DATE: 2eT/JdGt <br /> n <br /> APPLICATION#: <br /> Js, SOIL TYPE: �� F rL(1 DEPTH TO FIRST WATER: Ft <br /> REMARKS: Q <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> 0 <br /> R <br /> T <br /> ! lil ! II ! I Ii ll II i1 i <br /> I <br /> `T' , _= _ ' C -1 STT '—h_-1ZTCn <br /> , <br /> T 77 <br /> — <br /> I <br /> fD SOIL PROFILE(IF REQUIRED) <br /> Depth Soil Type De th Soil Type Depth Soil Type Depth Soil Type Depth Soil T pe <br /> '—(o ' <br /> M „ bl. „ c A, �I <br /> U) Test Hole#1 Test Hole#2 <br /> Parcel: I Diameter. in I Depth: in I Parcel: I Diameter. in Depth. in <br /> TIME READING WATER DROP REFILLEC TIME READING WATER DROP REFILLED <br /> 3 0 2.7 - �, i m <br /> o <br /> 00 G. <br /> s JD ' <br /> 5. j 2, G: / 3Z G.00 U) <br /> p:DO .7 n ” j t7 f92 2 Oo" a/ C) <br /> ! 12)/ 1 GS C) <br /> O 2 o <br /> 3, min/in PERCOLATION RATE: <br /> minlin <br /> PERCOLATION RATE: 8 AREA-. <br /> PE A <br /> RECOMMENDED SEPTIC <br /> RECOMMENDED SEPTIC A A: 5 P phone: ��'a- 7 '165a Date <br /> TEST PERFORMED BY: £ Date " <br /> TEST CERTIFIED BY: E Phone: s <br /> y Date � <br /> OBSERVED BY(RENS): �(IIIy) [I �11I,h1� Phone PES <br /> EHO 42.03 REV 172!09 <br /> nov <br /> CD <br /> O <br /> IN <br /> N <br />