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ADDRESS OR LOCAT I ON— <br /> OWNER—ft4;�r, clkL&,d <br /> AP ICATION NO. DATE b �/ SOIL PROFILE <br /> HG1 ~, (IF REQUIRED) <br /> (: <br /> DEPTI3�TO FIRST WATER: 3 SIZE OF BORING: j2 <br /> 1 .. b, �K- cy <br /> SOIL TYPE: d�:/ C-(Of <br /> REMARKS: 2 $ S <br /> LOCATION OF TEST HOLES (SHOW WELLS & STRUCTURES) 3- <br /> 4' <br /> '4' <br /> /V w <br /> 5' <br /> 6' <br /> / 7 ' <br /> 81 <br /> s• <br /> 10' <br /> TEST HOLE #1 TEST HOLE #2 <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> 14(4 <br /> 14,A) <br /> RD YV <br /> go %_ ,titr <br /> PERCOLATION RATE: '(Z� 19d� PERCOLATION RATE: <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: <br /> r TEST CERTIFIED BY: Sl'� <br /> OBSERVED BY (SANITARIAN) <br /> E!i 05 11 <br />