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� o <br /> v� <br /> 0 ID <br /> --I D <br /> h 0 � a <br /> a <br /> � r.r:-,.. N N <br /> O �^ <br /> Telephone:(209)468.3420 Fax:(209)464-0139 Web:www.sjgov.org/ehd n O N <br /> yr ^° O N <br /> r^ PERCOLATION TEST RATE u <br /> :3e+ F' <br /> ADDRESS OR LOCATION: _��_��_-�_g��- 14 w 4 2,6 CITY: S cp r- -ru j O m <br /> O OWNER NAME.�/LL SIN�H T 2 3 = <br /> 3 - -__ DATE: I� T-��T� <br /> R <br /> TYPE ! 6 _APPLICATION N: S�Z 60 / 3l-J fQ DEPTH TO FIRST WATER: -"n - Ft m <br /> fD SOG <br /> N <br /> REMARKS:QVC t.i 1-ck <br /> �5",-�:.__ ?,�I•tj��- (/1 <br /> S N <br /> - -- tD rr <br /> _ - O O <br /> r' n <br /> (D 1 AND STRUCTURES) X_ <br /> � - - CATION OF TEST HOLES(S O <br /> � - I (SHOW WELLS <br /> N i r_ I I _ � ,.-.- <br /> --0. <br /> -� — � <br /> r-r <br /> I <br /> n , <br /> -! -- - <br /> SOIL PROFILE OF REQUIRED) <br /> peach Soil T e De th Soil Type De th Soil T e Depth Soil T e Depth ' Soil T e <br /> 11- <br /> Test Hole ti i <br /> Parcel: Diameter: z_ In p - Test Hole N 2 <br /> �De lh: �p� in Parcel: Diameter: in Depth: in <br /> TIME READING _WATER DROP <br /> REFILLEp TIME READING_j J �� c- '7,,rC WATER DgOP REFILLED <br /> 'ERCOLATION RATE: s;Q <br /> — m)nlin PERCOLATIONRATE: <br /> 2ECOMMENDED SEPTIC A A: min/in <br /> EST PERFORMED BY: RECOMMEN ED SEPTIC AREA: <br /> 'EST CERTIFIED BY: _ Phone Date j,lJ <br /> ,6SERVED BY(RENS): r — Phone Phone:_ Date <br /> .o.;Da ,% Date ..S -`ZC7 - <br /> •loa _ <br /> PERC TEST RATE FORid '- <br /> DA <br /> t• <br /> Z77 <br /> (D <br /> 1 1 1 1 O <br /> t? <br /> O <br /> O <br /> (0 <br /> 1-" <br /> W <br /> (0 <br /> N <br /> DQ <br /> (D <br /> N <br /> O <br /> t� <br /> Nt <br />