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ADDRESS OR LOCATION <br /> . OWNER <br /> APPLICATION NO. /�S' �IO ' //6(--DATE �Z �' SOIL PROFILE <br /> DEPTH TO FIRST WATER: SIZE OF BORING : ( IF REQUIRED) <br /> 1 ' <br /> SOIL TYPE : <br /> 97 2 ' <br /> REMARKS : 'PfPC 51n6.eyy <br /> LOCATION OF TEST HOLES (SHOW WELLS & STRUCTURES) 3 ' <br /> 4' <br /> J <br /> 6 ' <br /> �eGrz�T <br /> 7 ' <br /> 3 ' <br /> -- /el 10 ' <br /> TEST HOLE #1 �QI> TEST HOLE #2 <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> cl <br /> /1� <br /> 2 00 '4 _ <br /> /Z- <br /> T-j <br /> PERCOLATION RATE : PERCOLATION RATE: <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA : <br /> TEST PERFORMED BY: <br /> TEST CERTIFIED BY : N i /Uo, 2 <br /> OBSERVED BY (SANITARIAN) <br /> EH 06 11 <br />