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ADDRESS OR LOCATION_ <br /> OWNER Ila z I <br /> APPLICATION NO. DATE �� �'� SOIL PROFILE <br /> DEPTH TO FIRST WATER : SIZE OF BORING: ( IF REQUIRED) <br /> 1 ' <br /> SOIL TYPE : �� O <br /> 2 ' <br /> REMARKS : �rT% " ' � <br /> LOCATION OF TEST HOLES (SHOW WELLS & STRUCTURES) 3 ' <br /> 4 ' <br /> 5 <br /> 6 ' <br /> 7 <br /> Z I I 8 ' <br /> z. <br /> 9 ' <br /> 10 ' <br /> TEST HOLE #1 CLflT �� TEST HOLE 42 ( z <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> 00 <br /> ld . oa �Zlk �� ' r /�' 6-- <br /> z� 3 <br /> Z�z <br /> Z ;Cl <br /> PERCOLATION RATE <br /> _ <br /> PERCOLATION RATE: ~I Z m��"sl�-,,��1� <br /> L� � <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA : ' ) <br /> TEST PERFORMED BY: L, <br /> TEST CERTIFIED BY: �ZON .v�-Pr•� /i f7, o zs- ' t i VET <br /> OBSERVED BY (SANITARIAP3) J U L 3 0 190 <br /> ENVIRONMENTAL HEALTH <br /> EH 06 11 <br /> PERMIT/SERVICES <br />