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NVIRONM AL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />-"" Telephone: (209) 468-3420 Fax: (209) 4640138 Web: www.sjgov.org/ehd <br />r� Q PERCOLATION TEST RATE <br />ADDRESS OR LOCATION: / Y7 3 Lam_. cr y: Z.,>_t� <br />OWNER NAME: DATE: /Z //f71�2 <br />APN: O 3 APPLICATION 9: SR DC, SY 56--1 DEPTH TO FIRST WATER: _Ft <br />SOIL TYPE: MI' <br />REMARKS: <br />LOCATION OF TEST H <br />HOW WEI <br />AND STRUCTURES) <br />TestHole#1 <br />•o in <br />' ,Diameter: <br />in De the in <br />- i <br />_ <br />Parcel �—Diameter: <br />fFia_rce1._:__1 <br />4.* in <br />De the <br />TIME READING <br />WATER DROP <br />REFILLED <br />TIME READING _ WATER DROP —REFILLED__ <br />0. <br />o' <br />7ERCOLpT10N RATE: <br />10miNin <br />PERCOLATION RATE: <br />minlin <br />ZECOAAAAENDED SEPTIC AREA: SFir <br />RECOMMENDED SEPTIC AREA: <br />'EST PERFORMED BY: Gl.�•� <br />Phone: __ . <br />Oft <br />EST CERTIFIED BY: <br />Phone: <br />Date <br />- <br />Phone616 f ° � �' <br />Date tZ ` t0 2. <br />B SERVED BY (RENS): <br />,, <br />PERC TEST RATE R <br />D 42-03 <br />104 <br />