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p4U{N SAN JOAQUIN COUNTY <br /> �o. ,t.coG ENVIRONMENTAL HEALTH DEPARTMENT <br /> y { <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> •' '• Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> �q��FORa`P <br /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: 0 CITY: /yI,4 I L� /� � �S'7 <br /> OWNERNAME: ` DATE: ALI&V`T /dr <br /> go-;Z-/ <br /> APN: <br /> APPLICATION 1 71M,DEPTH TO FIRST WATER: ^ Ft <br /> SOILTYPE: <br /> REMARKS: JAID t7A n!12/,V/' 'Al24 44IZ PR-f5-�A:ra1?,-4/ont <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES <br /> • 1 1 <br /> �44:[-L <br /> .. <br /> 9 <br /> _{ <br /> E i [ <br /> d ,........... ...... E ' ; { I l I i <br /> _... _._...... ._ _ ._. ._..__ - <br /> a , <br /> .. .._ ._ .. ...,a._..... ._.- _.. .. .._._ _ _. <br /> II v <br /> _j.._..1 ....__t.._,.. .......... <br /> u..........r .....W... ..........�r r `j _. _ _. ..... Y... <br /> .._._.`....�........ ' �_. I _. .... I i �..._..... I .. <br /> 111 _. <br /> f <br /> _.. _..,. _ r �� <br /> L ..... _. <br /> i <br /> -.. L ,......, _............ <br /> y <br /> } s I a <br /> ' <br /> 7.. <br /> SOIL PROFILE IF REQUIRED <br /> Depth Soil Type Depth Soil Type Depth Soil Type De th Soil Type. De th Soil Type <br /> yG D S - <br /> I <br /> Test Hole# 1 Test Hole# 2 <br /> Parcel: .o Diameter: S in Depth: in [Parcel: Diameter: in <br /> Depth: in <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> 0p <br /> p D <br /> %....3,k..._....__.............. _......... <br /> ...... . __._..._._._ _ _...._._......__.....__. _ <br /> ,U <br /> 1..x,_.30 .. ...�.,.�...._ _...�.,..�,� .�...__._..._.-_ M,.__...__.�...�..__ ._..� ..._... :_�.�_,.._..�,. <br /> PERCOLATION RATE: /j�. 7 min/in PERCOLATION RATE: min/in <br /> RECOMMENDED SEPTIC A: S E O�_ RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: E Phone: v20Q 402 -/65,V Date <br /> TEST CERTIFIED BY: Phone: Date <br /> OBSERVED BY(REHS): Chi Phone 20 J�1t'6 '3c'f� Date <br /> EHD 42-03 REV 11/2/09 PERC TEST RATE FORM <br />