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ADDRESS (ps' �, �Oc,k (�t1NG� Sic%�K PA# <br /> APN Su# <br /> PERC TEST PARCEL Perc DEPTH PERC RATE <br /> DATE OR LOT#. Hole# (feet) (min/inch) COMMENTS <br /> Z--�- �zl -pyo <br /> r �t l- L(2-' .be <br /> DATE SAMPLED TYPE OF WELL NITRATE mg/L DBCP ug/L EDB ug/L COMMENTS(other address for well sampled) <br /> /_�7'''Tl>� mo ,yS.r /l• r /%!:� N.�`.�t<' N�'ti��r�,�l rcJ �c�, <br /> NITRATE LOADING <br /> RESULT(mg/L-N) �" _ SR#: SR SR Date: Z•/Lo- z62 <br />