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/, /6 <br /> x I , T� r I <br /> ADDRESS ' ( S�O� 1N CW V� PA# �j�— 1A <br /> APN 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 LOADING _ <br /> RESULT(mg/L-N) SR#: SR �(' SR Date: <br />