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SR0082133
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082133
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Entry Properties
Last modified
9/3/2020 1:23:12 PM
Creation date
8/7/2020 8:54:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082133
PE
4222
STREET_NUMBER
23555
Direction
N
STREET_NAME
GRAHAM
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00727049
ENTERED_DATE
6/2/2020 12:00:00 AM
SITE_LOCATION
23555 N GRAHAM RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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Pq��N SAN JOAQUIN COUNTY <br /> 2 . ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> (. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> Qq c,FORa`P i <br /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: {�' �'J �.• t�� • CITY: <br /> OWNER NAME: _ , — DATE: <br /> APN: ' - -`( 1 APPLICATION#: DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE. 1 <br /> REMARKS: <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> 1 1 1 1 1 1 -t 11 I I I I I l I [l <br /> K. - <br /> . <br /> SOIL PROFILE (IF REQUIRED) <br /> Depth Soil Type Depth ( Soil Tyke Depth Soil Type Depth Soil Type Depth Soil Type <br /> 4_ - <br /> t - -- -- M <br /> Test Hole # 1 Test Hole # 2 <br /> Parcel;: Diameter: in Depth: in Parcel: Diameter: in Depthe in <br /> TmE READING WATER DROP REFILLED TI61E READING WATER DROP REr iLLED <br /> 0 <br /> 0 is <br /> If `t`3c^ <br /> li •oSa �� 2`I SS" I U 2y <br /> PERCOLATION RATE: min/in PERCOLATION RATE: minlin <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: Phone: Date <br /> TEST CERTIFIED BY: Phone: Date <br /> OBSERVED BY (REHS): Phone Date 7, <br /> EHD 42-03 REV 1112!09 FERC TEST RATE FORM <br />
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