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Address or Location: <br /> Owner: G-'\ >.L <br /> Application No. : Date: 3 <br /> i <br /> Depth to First Water: Size of Boring: 8 <br /> Soil Type: <br /> Remarks: <br /> Location of Test Holes (Show Wells & Structures) <br /> Soil Profile <br /> (If Required) <br /> 1. <br /> 2 . <br /> 3 . <br /> 4 . <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 10. <br /> TEST HOLE #04 8"fi x�i.1DI TEST HOLE <br /> Time Reading Water Drop Refilled Time Reading Water Drop Refilled <br /> 10.45 Z,19 �.3(0�+ -- Iv , Sc� 2 ,7 Co' <br /> 11. 45 x•02 (�'� — I ; S o 2 . �2` �•SZ" <br /> 12; i� 3.1/x/' So ,► 12",,,� Z. �� ` 2.1o4�� <br /> X2;45 2•�p' i ,ga' _ 'L;SD �boe>a Z,g 11 <br /> 20 -3 -05, 2 c; <br /> 4� 2 19 S q�" _ So 2,s,t Z �D <br /> z: 15 2113 - 16" -- 2zo <br /> 4- Pj0'('f oM Of:: 4rvFi i <br /> Percolation Rate: �� . /yji�i. �/�l, Percolation Rate: <br /> Recommended Sept(. Area: �2 Recommended Septic Area: <br /> Test Performed By: <br /> Test Certified By: <br /> E <br /> Observed By (Sanitarian) : f-6 * XP. <br /> `Q <br /> F:ISMMIS01UR. fA 0F <br />