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Address: 20814 N. Davis Rd, Lodi <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1866 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fox: (209) 464-0138 Web: www.sjgov.org/ohd <br />'/ <br />PERCOLATION TEST RATE <br />ADDRESS OR LOCATION: ?' MB y A/ CRY: FOG`S <br />OWNER NAME: C&7, DATE: 9 j$1s{ <br />APN' — y <br />• � APPLICATION e: DEPT TO FIRST WATER: ��•I---FI <br />SOIL TYPE: 'Lv Sim <br />REMARKS: -- <br />P <br />TEST PERFORMED BY: <br />TEST CERTIFIED BY: <br />OBSERVED BY (RENS): �i+k <br />EFw 1243 REV 11f2" <br />Phone: —_ —_. „V �•` Date <br />Phone: Date <br />Phone —ZO�� Date <br />I M:R'„ TAT RATE FARM <br />Naseem Ahmed, Registered Environmental Health Specialist <br />ID: SR0084236 <br />