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psgU1N SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />_� 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PERCOLATION TEST RATE <br />ADDRESS OR LOCATION: -?'Iq Z W ' E:Xj vi-IN`9 CITY: -TR- <br />OWNER NAME: -b" G- T�t S � Z Z <br />c1 DATE: Z 3 <br />APN: 7- k •-7-3o — of APPLICATION #: -v-OO �t DEPTH TO FIRST WATER: Ft <br />SOIL TYPE: CL -?n, L-C&VV\ <br />REMARKS: <br />LUGATIUN OF 1 t5 I HULLS (SHOW WELLS AND STRUCTURES) <br />.....-.v_...... --, .... ._i _t._....-......... ........ a_—i..._.__........ . . �.. __;�1 t.......1— <br />__- PERCOLATION TEST SKETCH �__„•- `` PERCOLATION TEST SKETCH <br />.......... <br />2” Diameter PVC Pipe i ` 2 Dia "r RC Pipe <br />�..._..... _ ......... __7_.. <br />5.i til f <br />_ <br />... <br />'�- ..... <br />_............ <br />• " x ' 0.17' gravel E i 0.1T pravei <br />Q i <br />Refill Level: ' "� 43 -'�- Refill Level: - <br />.........;.........: <br />i <br />I <br />R011 PROFII F 1IF RFn1IIRFnl <br />Test Hole # 1 <br />Parcel: Diameter: in I Depth: Z <br />---------- <br />Test Hole # 1 <br />Parcel: Diameter: in I Depth: Z <br />F ,OLATION RATE: min/in <br />RLvOMMENDED SEPTIC AREA: <br />TEST PERFORMED BY: <br />TEST CERTIFIED BY: <br />OBSERVED BY (REHS): M <br />EHD 42-03 REV 11/2/09 <br />Test Hole # 2 <br />Parcel: Diameter: in Depth: <br />TIME READING WATER DROP REFILLED <br />PERCOLATION RATE: min/in <br />RECOMMENDED SEPTIC AREA: <br />Phone: CS09) 365 X03*S Date 7- <br />/'Z 7 <br />Z7- <br />Phone: <br />2Phone: Zol 3(ai- oars Date 2--7,3-VZ <br />Phone 76--t -64` 7- 341 .5' Date Z,1Z .s ( Z -Z <br />PERC TEST RATE FORM <br />,: <br />•ffffA <br />F ,OLATION RATE: min/in <br />RLvOMMENDED SEPTIC AREA: <br />TEST PERFORMED BY: <br />TEST CERTIFIED BY: <br />OBSERVED BY (REHS): M <br />EHD 42-03 REV 11/2/09 <br />Test Hole # 2 <br />Parcel: Diameter: in Depth: <br />TIME READING WATER DROP REFILLED <br />PERCOLATION RATE: min/in <br />RECOMMENDED SEPTIC AREA: <br />Phone: CS09) 365 X03*S Date 7- <br />/'Z 7 <br />Z7- <br />Phone: <br />2Phone: Zol 3(ai- oars Date 2--7,3-VZ <br />Phone 76--t -64` 7- 341 .5' Date Z,1Z .s ( Z -Z <br />PERC TEST RATE FORM <br />