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ADDRESS 11:757 I V D1,A) i S U Lod IPA# p� �IWO 5,-? <br /> APN Q ss - -Z20 )(P 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 hh <br /> RESULT(mg/L-N) ✓ SR#: SR V —D J{ <br /> ? SR Date: <br />