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• - Y <br /> OWNER ADDRESS OR LOCATION <br /> P.M. or S. NUNIBER: DATE : <br /> SOIL PROFILE <br /> DEPTH TO FIRST WATER SIZE OF HOLE: ( IF REQUIRED;, <br /> 1 ' <br /> SOIL TYPE: 2 , <br /> REMARKS: 3' <br /> 4' <br /> LOCATION OF TEST HOLES ON PROPERTY 5' <br /> (SHOW ANY WELLS AND STRUCTURES) 6' <br /> _ 7� <br /> B' <br /> �rec_ c,r- W� S vLc4 re S c '� <br /> c� e r v uk i c,, v `f <br /> 0 <br /> TEST HOLE #1 TEST HOLE #2 <br /> M R [' G W R RO R ILL TIME READING W R DROP" R FILLB <br /> . oc 31 <br /> 1 . 30 X12 �� 3 9 33 GZ <br /> /a5 ,��f <br /> Z 33 <br /> Nl <br /> L/.�J ✓7 64 65J <br /> .� 30 2 � •3 fv0 <br /> 5 00 <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) (R.C.E. or R.S. #) <br />