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OWNER 1. ADDRESS OR <br /> P.M. or S. NUMBER: DATE ; <br /> S011. PRO! I Lt <br /> DEPTH TO FIRST WATER SILL OF HOLE : — _ _ Or RIOUIRED)_ <br /> SOIL TYPE: <br /> REMARKS: 31 <br /> 4 ' <br /> LOCAIIUN OF TEST HOLES ON PROPERTY 5' <br /> (SHOW ANY WELLS AND STRUCTURES) b , <br /> 71 <br /> ` 8 <br /> I -- <br /> '_^�ntl,- 0,31 l6,,, TEST HOLE '� ULLED <br /> ►+sites ;%� _M — — -TEST HOLE #2 <br /> W R R IMR-ULTI-96' ATER6R-0P REFILLED <br /> t <br /> PERCOLATION RATE: PERCOLATION RATE: <br /> RECOMMENDED SEWAGE DISPOSAL AREA: RECOMMENDED SEWAGE DISPOSAL AREA: <br /> TEST PERFORMED BY : TEST CERTIFIED BY: <br /> OBSERVED BY (SANITARIAN) ( . V- (R.C.E, or R.S. <br />