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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Q: ,a <br /> 0. { 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> PERCOLATIO{�N TEST RATE <br /> ADDRESS OR LOCATION: or 0, ..' r CITY: �o� <br /> OWNER NAME: C C DATE: C Z <br /> APN: D S- I k S U U-1 O APPLICATION#: 0 DEPTH TO FIRST WATER: N f Ft <br /> SOIL TYPE: s ° ^ 110-120 feet <br /> REMARKS: /V <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES <br /> i <br /> : <br /> I ! ! <br /> I .-' ► i i i I I o ; I ! __( _I i - 1 ----------- <br /> I_.. t—r---T^ <br /> lit <br /> ! 1 <br /> ! <br /> _-` - ! <br /> T <br /> I I �! .' I ..._ _.FS —I—� <br /> s <br /> ' ' <br /> — �__. <br /> SOIL PROFILE IF REQUIRED <br /> Depth Soil Type Depth Soil Type Depth q2ljype Depth Soil Type Depth Soil Type <br /> I ; 1-„,1 f:l4 <br /> 3 , <br /> Test Hole # 1 Test Hole; <br /> Parcel: Diameter: 4.0 in Depth: 42 in Parcel: Diameter: in Depth: in <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> O <br /> CI 00 3 .2 �! ' �� Z . 71! ' ;230 ?, , t�q 3111 2- 2 <br /> 0K30 3.2 `I ” Lbs_ 2 • 0 G <br /> l00O 3 , 2 �� �: �� A <br /> D . 7s ' <br /> <<5 <br /> 03V 3 , zZ 14-7, 2 , 70 , <br /> it' Lio �!3 ` 2" 71 <br /> ISo 3 , is � It z - 7 � <br /> - -)3 ' 2 . <br /> PERCOLATION RATE: "L . G 1`1 min/in PERCOLATION RATE: min/in <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: C i, rrl L_ Phone: Date <br /> TEST CERTIFIED BY: Phone: Date <br /> OBSERVED BY (RENS): (IP0 Phone Date <br /> EHD 42-03 REV 11/2/09 z PERC TEST RATE FORM <br />