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aoP SAN JOAQUIN COUNTY <br /> �r- ENVIRONMENTAL HEALTH DEPARTMENT <br /> x, 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:%vww.sjgov.org/ehd <br /> `'FO�a PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: Z 15-0 Z s• s A IF t CITY: E,ySC^L-y�.J <br /> OWNER NAME: -D� S y I D ft�N Kr DATE: /0`'v 4 9 <br /> APN: 2-1+91 - 19 - 13 APPLICATION#: DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: 6 SA.c/D wI 5,LT A,'`f1 Gi/.l,�r-.SAA10 w f G ai <br /> REMARKS: <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> _ PERCOLATION TEST SKETCH _.__.. Y_ ! ' PERCOLATION TEST SKETCH _ <br /> 2-INDIA.PVC PIPE 2-IN DIA.PVC PIPE/ <br /> 4-IN DIA.SOIL BORING 4-INDIA.SOIL BORING <br /> a , <br /> i <br /> _._ .. I.......... ..--......__..... - <br /> gro Jul O.2 <br /> REFILL HEIGHT 3'ky —) 3 REFILL HEIGHT — <br /> _._.. <br /> SOIL PROFILE IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> ikl S11r-it4K-SRNJ 5 I f <br /> /�'4L 'SA--14 e..t'es <br /> Test Hole#1 -3 Test Hole#2 <br /> Parcel: Diameter: in I Depth: Parcel: Diameter: in I Depth: <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> L7 C) <br /> 3a <br /> 06 <br /> 3 o 0 q I <br /> �o .-1 7 . & 3 3,-y 7 <br /> t d-30 <br /> 3110 . 13 3,9d <br /> ;no <br /> q ,00 3,6 <br /> 3o 3.71 << <br /> ta:Un <br /> PERCOLATION RATE: --_— O __minlin PERCOLATION RATE:_----_—_—__---minlin <br /> -COMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: _----__—__--_ <br /> 'ST PERFORMED BY: o 14g-eo Phone:40 01- 60 !g'o Date <br /> TEST CERTIFIED BY: _ _ Phone: Zoe -32,j --0I9 k Date 11- <br /> OBSERVED <br /> 1=OBSERVED BY (REHS): PhoneDate T �� <br /> EHD 42-03 REV 1112/09 PERC TEST RATE FORM <br />