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o = o <br /> Lr� <br /> O ID <br /> D <br /> D O 0- <br /> O ro <br /> MN I'--L <br /> O <br /> rn O ON <br /> = d LO <br /> ,y O) <br /> O N <br /> 00 I , SAN JOAQUIN COUNTY <br /> 3 ENVIRONMENTAL HEALTH DEPARTMENT <br /> :3 �'� 1868 East Hazelton Avenue,Stockton,CA 95205-6232 <br /> yc•`' Telephone:(209)468.3420 Fax:(209)464-0138 Web:www.sjgov.orglehd S d <br /> 4''iea M ` <br /> = PERCOLATION TEST RATE M - <br /> lD r// rD <br /> ADDRESS OR LOCATION: <br /> OWNER NAME: 'VII(`-,IjA,1(^ n rfQ- DATE: I J <br /> -0 APN:- 03 Z z-) L'4 APPLICATION 0: DEPTH TO FIRST WATER: Ft r <br /> _— <br /> SOIL TYPE:S I I,•l./ �'T,�. <br /> 2L REMARKS: -O <br /> e- <br /> rF <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> I I I D I I I I 1 1 i i i i I I i I I' <br /> I_ I_ L �! I-! - - <br /> ! Ii lilt I <br /> IIII I I ': II III I <br /> I I -1-F-1 I I I I I I_I I I I I I II I III I I I <br /> SOIL PROFILE(IF REOUIRED) <br /> De th Soil Type De th Soil T e De th <br /> Soil T e De th Soil T e De Soil T e <br /> t <br /> Test Hole#1 Test Hole#2 <br /> Parcel:_ Diameter: 1 in Dent in Parcel: <br /> Diameter. in Dethe <br /> in <br /> TIME READI WATER DROP REFILLED <br /> TIME READING WATER DROP REFILED <br /> #o <br /> A qs b 6O <br /> 5 A 5b <br /> 5 <br /> 56 <br /> minlin <br /> minlin PERCOLATION RATE: <br /> PERCOLATION RATE: RECOMMENDED SEPTIC AR Date <br /> RECOMMENDED SEPTIC AREA: Phone: Date <br /> TEST PERFORMED BY: Phone:�— <br /> ,/ <br /> TEST CERTIFIED BY: fl �ti9� phane� Date pERCTESTRATEFORM ID <br /> OBSERVED BY(REHS) 00 <br /> 0 <br /> N <br /> v O <br /> OTa O <br /> lD 00 <br /> O LriW <br /> N <br /> v <br />