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OWNER_ J0 �,r\ �d r ADDRESS OR LOCATION <br /> P.M. or S. NUMBER: DATE: 3 -► �- �� <br /> DEPTH TO FIRST WATER, N/A, SIZE OF HOLE: / � SOIL PROFILE <br /> ( IF REQUIRED) <br /> SOIL TYPE: N/}-�2t7 �PSrJ / s I t.T�( C�f.�� , �An1f) 1 ' <br /> REMARKS: <br /> 3' <br /> 4' <br /> LOCATION OF TEST HOLES ON PROPERTY 5' <br /> (SHOW ANY WELLS AND STRUCTURES) 6' <br /> 7, <br /> i 8' <br /> A q <br /> rj <br /> TEST HOLE jt�3 TEST HOLE its 7r <br /> R R ZS o� IM R A R FILLE <br /> 2 , %5 <br /> cj D 2 6,7 5 OrSD Gl' ;1r 3 /,SD 7S 20,5o <br /> 2T,(s- 45- 3 Z0 Z,70 29,40 <br /> Io; i o 2 ,50 (�,3s 10 ; 15 ;I , -7S z,"�a 2�,7s <br /> 4-0 2 7 U,Z5- 10 4 7- v, G� <br /> V I 11/0 00 0/z� ,- I I 'pis I 7u SO 2 ,Cto ZY,ZS <br /> 0 ,140 (,,Z5- ll �S 3Uso ,Z� Z G,Z� <br /> Ic, ZY,S0 Z' Z,2- <br /> 11. 1 'L�,1 S Q,2 I Z c+ 3o,00 2 r 10 1 <br /> PERCOLATION RATE: /� /wiC, PERCOLATION RATE: /y.7 mow;-•lr..�iL, <br /> RECOMMENDED SEWAGE DISPOSAL AREA: RECOMMENDED SEWAGE DISPOSAL AREA: <br /> Z UvcJ S,r ,- r <br /> TEST PERFORMED BY: Q G I(-m h.j TEST CERTIFIED BY: l;zlt q ,l <br /> OBSERVED BY (SANITARIAN) �'�. j �� ktc, (R.C.E. or R.S. -3 S cu 3 <br /> EH 13 11 <br />