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ADDRESSPA# Ik <br /> _r J <br /> APN SU# I <br /> PERC TEST PARCEL Perc DEPTH PERC RATE <br /> DATE OR LOT# Hole# (feet) (min/inch) COMMENTS(PASS/FAIL) <br /> DATE SAMPLED TYPE OF WELL NITRATE mg/L DBCP ug/L EDB ug/L COMMENTS(other address for well sampled) <br /> n <br /> NITRATE LOADING <br /> SR SR Date: <br /> RESULT(mg/L-N) SR#: ll)) <br />