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SR0084017
EnvironmentalHealth
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MICKE GROVE
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4200/4300 - Liquid Waste/Water Well Permits
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SR0084017
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Entry Properties
Last modified
8/23/2021 12:14:40 PM
Creation date
8/23/2021 11:20:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0084017
PE
4222
FACILITY_NAME
11250 N MICKE GROVE
STREET_NUMBER
11250
Direction
N
STREET_NAME
MICKE GROVE
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05914057
ENTERED_DATE
8/2/2021 12:00:00 AM
SITE_LOCATION
11250 N MICKE GROVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Tags
EHD - Public
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Site Address: 11250 N. Micke Grove Rd, Lodi <br />Date: 8/3/2021 <br />PHOTO #1 Percolation Test Sheet. <br />Tdrlapbone: (209) 468-3420 Far. (209) 484-0138 web: www.sjgov.orglehd <br />PERCOLATION TEST RATE <br />Record ID SR0084017 <br />ADDRESS OR LOCATION: 11/ZTO n1 • PAts.� ya " CITU: iii <br />OWNER NAME: i11M CK..� U.C. ... G!o Jack DATE: $-3--LA-I <br />APN: OSY I��' -5 APPLICATION N: DEPTH TO FIRST WATER: _Ft <br />SOIL TYPE: <br />REMARKS: <br />TIME <br />READING <br />WATER DROP REFILLED <br />i <br />2•`tk <br />p <br />_ <br />3.00 <br />oS <br />,os <br />01 <br />i: 3S3 <br />I z <br />0 6-7 <br />0 :06 <br />;.10 <br />0.0(0 - <br />/0: 3D <br />- 3• <br />0.04 _ <br />(t : lY1 <br />31.0S <br />S <br />It. 35 <br />.oI <br />G•a <br />t2: o� <br />QV <br />.o <br />PERCOLATION RATE: „li0 minfin <br />RECOMMENDED SEPTIC AREA: <br />TEST PERFORMED BY: ::fgAnL a��_ <br />TEST CERTIFIED BY: <br />OBSERVED BY (RENS): <br />V0*2-W REV 1112M <br />TIME <br />READING <br />WATER DROP REFILLED_ <br />i <br />2• 1 <br />p <br />oS <br />,os <br />0 bk - <br />i: 3S3 <br />I z <br />0 6-7 <br />10-.05,._ . <br />1$ <br />0 ou <br />—66 <br />)0 : 3S <br />- 3• <br />It. 35 <br />2 • z <br />-- <br />L : S <br />z •'� <br />� n, ob - <br />0 <br />0 <br />PERCOLATION RATE: minim <br />RECOMMENDED SEPTIC AREA: <br />Phone: 26g4,Z4L Date 2Oz <br />Phone: Date _ <br />Phone Date <br />Page 1 of 1 <br />Daria Afonskaia, Registered Environmental Health Specialist <br />
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