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-0W <br /> =O CD <br /> r 0O Q. <br /> CL <br /> p CD <br /> cn cri <br /> IV <br /> IV A <br /> mm <br /> n � <br /> O <br /> Z� <br /> - _ o <br /> a* 0 <br /> r-« <br /> ilv �r'- •0 3e Web:wwwy <br /> slgov or/enH <br /> PERCOLATION TEST RATE <br /> CD <br /> ADDRESS OR LOCATION: '/ C <br /> 7 C+sT Gn "• (7 <br /> OWNER NAME: F'T' X41 1 S / + CITY. '?Fil;ii'A ;( T.- - O <br /> AVN: l-)?_/n�j / -- DATE: A/!I l:il e• c- Q <br /> APPLICATION r: DE""TO FIRST WATER�— <br /> SOILTYPE. 2FC 6E <br /> f^FLf+N� -- <br /> REMARKS:— --- - <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) O <br /> O <br /> cn <br /> alT�TTJT <br /> cn - - - - - - - <br /> l T <br /> (D --- - - - - - - ---- - - -- -- -- -- <br /> ; SOIL PROFILE(IF REQUIRED) <br /> = De th Soil T e De th Soil Type Depth Soil Type Depth Soil Type Depth <br /> Soil T pe <br /> ` u � <br /> m - A <br /> _ }-G <br /> U) <br /> Test Hole#1 Test Hole#2 <br /> Parcel: / Diameter: in I De t1=,=i Parcel: / Diameter; S In ,Depth in <br /> TIME I READING %'NATER DROP REFILLED TIME READ NG "JTER DROP REFILLED <br /> 3 9, v' :3 2- 1 7. <br /> O I <br /> 3,06" l 02 1 4. <br /> 30 z 1' 1 2.01' ,__ ;- <br /> O <br /> Z1 0 5` 7 <br /> O 3. <br /> 2,04"1 <br /> .0 "11,2 3ZOO/ 311r I %�' <br /> O 1.97' <br /> 30 4,9 2- 2 o8" I cD <br /> D '9.94' 2.2 2.gor :,?22 �r <br /> p 7 ' <br /> -p 2.1 /- 3Z 13.t5I <br /> I I <br /> PERCOLATION RATE: Z3 minlin PERCOLATION RATE: minlin <br /> RECOMMENDED SEPTIC REA: RECOMMENDSP SEPTIC AREA: <br /> E Phone.�9 `n x`58 Date //,a tu/4 <br /> TEST PERFORMED BY: Date <br /> TEST CERTIFIED BY: I E Phone: <br /> Date <br /> i i- ,> !t.l ICU/ <br /> OBSERVED BY(RENS): Phone� pERC iE57 RATE FORM <br /> EHE 42-03 REV 11/2M <br /> 0 <br />