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nI' <br /> O D <br /> D O � Q <br /> r(n <br /> Ln <br /> -o 0 <br /> M C) 00 <br /> O (JT <br /> 1 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd w m <br /> �, p.'• <br /> O1176 PERCOLATION TEST RATE 3 00 <br /> � c <br /> ADDRESS OR LOCATION*. S E. aK✓NSW 1 C r, R�, CITY: MA'^TE r'A CN <br /> N G <br /> 7 OWNER NAME: �+G�vJ p1 rv11N LO GE2 DATE: 2'14-•2G - rT <br /> /D APPLICATION 0: fL o G,�1-)(v-9-7 DEPTH TO FIRST WATER: =3 Ft <br /> = SOIL TYPE, E 1 LoR (D �0 <br /> (D REMARKS: Snw, J„ 0'wj 4,r vL•1.cont�.✓c n•<'n Q <br /> r-F rt <br /> S D) <br /> (n LOCATION OF TEST HOLES(SHOW WELLS AND ST RUCTURES) 3 <br /> PERCOLATION TEST SKETCH �i PERCOLATION TEST SKETCH _ <br /> - <br /> >v <br /> DJ' :_ 2-N DLA.Pvc PIPE: .. <br /> 2-IN DIA.PVC PIPE' �- <br /> tn• , .IN DLV SolL BORING 4-I`n1:\.SOIL BORING <br /> 4 <br /> :j- I <br /> El�i l_. <br /> g.z•t• - �. _ �Lr. <br /> _ I_ <br /> I - <br /> --?REFILLHEIGHT <br /> SOIL PROFILE IF REQUIRED <br /> Depth Soil Tye Depth Soil Type Depth Soil Type Depth Soil Tye Depth Soil T e <br /> p_4" 5711-1s.nit <br /> Test Hole#1 Test Hole#2 <br /> Parcel: I Diameter: sl in Depth:3,"' Parcel: Diameter: in I Depth: <br /> Tine RETrnoc, Wnr Dr+u Renu.°ri Tip- Re;GREFi. <br /> q•-cv D,� — ZS <br /> a iF•s9 0.3�} 3! <br /> lo.ov �{•!eD b.Z�) 3� <br /> 10,50 E1.56 U.2 I.3I <br /> JI-do 4 0,.lu X1.3 -- -- - -- <br /> //� <br /> r2.3o y,S 0,2 4• 1 <br /> PERCOLATION RATE:_--1— ----minfln PERCOLATION RATE: ,—minlin <br /> RECOMMENDED SEPTIC AjEA: _ _—_— RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: ---- Phone: Data LO <br /> TEST CERTIFIED BY:__.__. _ __ Phone: .._.__ __ Date <br /> OBSERVED BY(REHS}:_ ---= '-✓------- Phone____—_-_—_ Date /I� 70 <br /> EHD 4203 REV 11rtl09 FERC TEST RATE FORM <br /> 0a 0 0 <br /> rD <br /> 0 <br /> 0 <br /> 0 <br /> m 0 <br /> Do 0 <br /> (D DQ <br /> N .I <br /> rn <br /> 0 00 <br /> --h V <br /> N <br />