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f <br /> Site address: 18739 N. Clements Rd SR0081596 <br /> +�j s ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1 600 East Main Street,Stockton,CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)484-0138 Web:WWW.ajgoV.orglehd <br /> �C4�'•4 <br /> PERCOLATION TEST RATE <br /> ADDRE880RLOCATION: (9-139 AI• CL£1'ti'ICAj-j /Lj> LADI <br /> O*NERNAME: I>C"-JIS GC'o2GAToi clT': <br /> ApN:_ O!9 2 oy-3 g DATE: r- <br /> —L nPe CreRRSE\ <br /> APPLICATION y: DEPTH TO FIRST WATER: Ft <br /> 2t-�j SILr�1 SAryn <br /> REMARKS, <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> PERCOLATION TEST SKETCHi -• PERCOLATION TEST SKETCH <br /> —, , <br /> 2-IN DIA.PVC PIPE --L-�-�-� 2-IN DIA.PVC Ptl'B, <br /> I Uhl <br /> 1-IN DIA,SOIL BORING -i I I 4.IN DIA,SOD.BORING <br /> REFILL HEIGHT RFI•L.L TIF.IfiTir <br /> - I —_._.. --- - i i- 1 I I <br /> SOIL PROFILE IF REQUIRED <br /> Depth Sall Type Depth Soil Type Depth Soil Type 1 Depth I Soil Type Depth Soil Type <br /> 9� <br /> Test Hole#1 Test Hole 1112 p <br /> Parcel: I Diameter: in I Depth: ].19 Parcel: Diameter: In I Depth: Z <br /> TIME READING WATER DAGP REFILLED TINE READING WATERDRDP REFILLED <br /> to-.-IV 3•-1 e•''1 <br /> tD • io y.L-1 0.53 3•11 <br /> 11 .ca 'h•o 1 0.31 3.11 <br /> 3fl14.o o•33 3•-l0 <br /> IZ o-o ,o1 0.31 1 3.80 <br /> 30 4-.os 0•7.5 3•410 <br /> ob 4.11 0•Zt `)l <br /> x•.30 If ) <br /> • <br /> PERCOLATION RATE:___ Z_minlin PERCOLATION RATE:_ _mInlin 0 1 • 1 <br /> RECOMMENDED SEPTIC AREA; RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY:_ _ Phone: Zo 1-366-111L Date r-Y-�o <br /> TEST CERTIFIED BY: Phone: _—____ Date <br /> ro+^A — - Phone f-N 4$ 3Date <br /> OBSERVED BY(RENS): — <br /> PERC TEST RATE FOGA <br /> EHD 42-09 REV 11rzro9 . <br /> Naseem Ahmed, Registered Environmental Health Specialist <br />