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u I'N SAN JOAQUIN COUNTY <br /> -�� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:4vww.sjgov.org/ehd <br /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: 9-�L-�4 S, CITY: Ste( 1GTZrJ <br /> OWNER NAME: DATE: <br /> APN: 11P2 - i d D -03 APPLICATION#: rDEPTH TO FIRST WATER: Ft <br /> SOIL TYPE:� l S j:l�� Cl��/ °. �. S'3-C� 5u�4� .S 1 / -414%1 3,64 5/' 14Y5CcyLq <br /> REMARKS: <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> _ PERCOLATION TEST SKETCH _ - i i PERCOLATION TEST SKETCH - <br /> 1 <br /> 2-IN DIA.PVC PIPE/ —` 2-IN DL4.PVC PIPE/ <br /> 4-IN DIA.SOIL BORING I I t ( ! 4-INDIA.SOIL BORING I <br /> 07 S t <br /> r 3 x <br /> - <br /> _ y3q �......�. , ; . <br /> REFILL HEIGHT ! I REFILL HEIGHT e <br /> SOIL PROFILE(IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> r� SiI� Ga <br /> Test Hole#1 Test Hole# 2 <br /> Parcel: 1 Diameter: in I Depth: 3`9 " Parcel: Diameter: in I Depth: <br /> TIME READING VVATE:=,DROP REFILLED Tim_= RE.AE'13 (NATE:�;DRc'I: R=.=i _E <br /> /0 : vo5ky q. 35 <br /> /o- 30 4,39 <br /> . i4, 3 <br /> 3c, <br /> L4& 3� <br /> la % 30 <br /> I ; <br /> 00 <br /> 3b q. '50,0 43 Sr <br /> 4 1_*5 <br /> PERCOLATION RATE: _—_ -3 min/in PERCOLATION RATE: _----_—_—__---minlin <br /> ZECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> FEST PERFORMED BY: ��? Phone: _7���0 8 l�o Date S !i <br /> ;r-'------- - ------ <br /> TEST CERTIFIED BY: _ Phone: 2o�_�L5_oi�I Date V - <br /> OBSERVED BY (REHS): <br /> - -- <br /> _— _ I v <br /> — —__ Phone__--_—__--_ Date <br /> EHD 42-03 REV 1112/09 PERC TEST RATE FORM <br />