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(rD <br /> �• O m D <br /> 00 a- <br /> o w CL <br /> N (D <br /> v m o <br /> �• c 00 <br /> o N <br /> N <br /> m O <br /> < e>4 +ate SAN JOAQUIN COUNTY <br /> O m <br /> Qy�I ENVIRONMENTAL HEALTH DEPARTMENT 3 <br /> O 1': 600 East Main Street,Stockton,CA 95202.31)29 (D <br /> Telephone:(209)468-342G Fax:(209)484-0138 Web:eb:wwwsjgov orglehd _ <br /> O PERCOLATION TEST RATE (D <br /> 7 N <br /> e•-F ADDRESS OR LOCATION: '"'LTQ S N <br /> E• KeT7 LEIN rk Iv L r m <br /> _ OWNER NAME: SL)kH /I✓DETZ 119A-AIV CITY: QLUD) <br /> (p APN: O(,3- IGD-l o <br /> APPLICATION k: SRuO b-239'l <br /> SOIL TYPE. Tcic p/NCS��p �A DEPTH TO FIRST WATER: FI r <br /> �- REMARKS: O <br /> N <br /> Q <br /> (D <br /> Q. LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES <br /> N' PERCOLATION TEST SKE — - -- <br /> r-r TCH <br /> --_ PERCOLATION TEST SKETCH i <br /> 2dN DIA.PVC PIPE <br /> 4-L%DL4.SOIL.BORLNG -—- -IN DLI.PVC PIPE., <br /> 4-IN DIA SOI.BORING I <br /> 3.(( <br /> .16 �y �l <br /> ._REFILL HEIGHT <br /> RPf aL ro-lcrrr <br /> SOIL PROFILE IF REQUIRED <br /> De th Soil T e Depth Soil Type Depth Soil T pe Depth Soll Type Depth Soil Type <br /> O- 37 r <br /> s: <br /> Test Hole it 1 Test Hole#2 <br /> Parcel: Diameter: q in I Depth: 3.1- Parcel: Diameter: in I De the <br /> TIME RF DNG jl �P RFFILI._J TIME RE;oYG VSIEF:DW REIN..c::' <br /> 8•0o D Z <br /> 30 4. Z q. <br /> vv �7 .37- 4 N <br /> -1 30 <br /> Q 00 A.- _ _._. -- <br /> (I vuI 2l q.14 � <br /> I(:30 76 . I 'f r <br /> t <br /> PERCOLATION RATE:—__ ZS _minlin PERCOLATION RATE: mid" 0 <br /> _ __ _ RECOMMENDED SEPTIC AREA: <br /> RECOMMENDED SEPTIC A _ - g <br /> TEST PERFORMED BY: ---- Phone: q 360 03 � Date <br /> TEST CERTIFIED BY: _y-- Phone: ..-- — --- P <br /> _ _ Date <br /> OBSERVED BY(RENS): � - Phone________ Date - t <br /> LHO 92-03 REV 11009 1 PERC LEST RATE FORM <br /> ��>i-z <br /> (D <br /> C) <br /> O <br /> CL <br /> Sn <br /> UQ �O <br /> O O <br /> N O <br /> O 00 <br /> h N <br /> N W <br /> i.D <br /> Ili <br />