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pqU?y SAN JOAQUIN COUNTY <br /> 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 /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: ��¢�� {' G/(PZz E. Yy1eV-1 F6s A it—b. CIN: S7ZDGk777'-J <br /> OWNER NAME: A-10&GL,A RArgA,A S DATE: 4-1/Z3/7_ 1 <br /> APN: 1 I - 0r-OL- I I / APPLICATION#: S IZQO S 3 a;63 DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: ,J(tiC(��✓ c C I(a L Z &6L L'1' G IG <br /> REMARKS: <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> �__ _t_.._...J._t—t._ 1 '► i _.� t i e i i._..._..i,_....�. t_ �.� �.......� �. ---�.k T.t l_-.-i 1—i—.-1—t_d I-3-._..' <br /> PERCOLATION TEST SKETCH ! i _ PERCOLATION TEST SKETCH <br /> 2"Diameter PVC Pipe I i 2"Diameter PVC Pipe <br /> __' ;......_. ._....... <br /> ; I I <br /> . 1 <br /> ............ <br /> A.Fkl ..._._ <br /> ••"^^' 0.17'gravel 0.17'gravel <br /> -' <br /> Refill Level: <br /> f Refill Level: <br /> : ....... <br /> -- <br /> SOIL PROFILE(IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth soil Type <br /> 0- 5f C'la <br /> Test Hole # 1 Test Hole# 2 <br /> Parcel: t Diameter: L4 in Depth: 3, 1 U Parcel: I Diameter: y in Depth-, I'3.L(6( <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> 9, 00 ly. ' -5, L(.7, moi:p l pr', Z$ <br /> CA, 30 25 .00 �t. 31 Iy .N J6 <br /> )0'. 00 Z5 vc — 10:© I l�I: /' <br /> _j 0 '. 3(D `-I ,26 •01 — 101, 31 IN. ✓:, Z - it i L( - . y <br /> Il : oo L.I 2,( 1—. Oo ) ( : 01 1 y <br /> 11: 3o Z`�- -U — 11 . 3 1 14 - 153 I Z L I . C-( I <br /> ► 2: vo `-I 2-i- .00 — 1210 ( ISI. 53 . !Z 1q . 37 <br /> 171 310 .00 — ! Z .31 01Cl, 5 . IT- 14S <br /> 'COLATION RATE: 2 50 min/in PERCOLATION RATE: 27,• -q•3 min/in <br /> K—%;OMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: Phone:(_&O5) 36q- 03-+ Date k Z3/Z I <br /> TEST CERTIFIED BY: Phone: Zoe .3(.c,- 03-) Date q-23 - 7- 1 <br /> OBSERVED BY (RENS): Phone Date V ?4`L <br /> EHD 42-03 REV 11/2/09 PERC TEST RATE FORM <br />