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ADDRESS 5 5 J �Q f�-. . PA# <br /> APN 0e(0 � "� SU# <br /> PERC TEST PARCEL Perc 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 /> NITRATE LOADINGA <br /> _ h j f <br /> RESULT(mg/L-N) t� SR#: SR 0V� UO�/ 6 SR Date: l <br />