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p4!?!!! SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />"• 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />sY Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PERCOLATION TEST RATE <br />ADDRESS OR LOCATION: <br />OWNER NAME: <br />APN: 651 Irl t <br />SOIL TYPE: SS <br />n <br />REMARKS: %-, )!� l <br />APPLICATION #: <br />CITY: 1 oe.' A <br />DATE: 12--P— <br />DEPTH <br />� <br />P <br />DEPTH TO FIRST WATER: 6✓� Ft <br />LUGA I IUN OF I t5 1 HULtS (SHOW WELLS AND STRUCTURES) <br />I t <br />—._ • _ I L— -- t —5—� <br />SOIL PRC)FILE !IF RF0l11RFm <br />Depth Soil Type De th Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br />!1 'C�,,� ,t <br />G P 'tr <br />Test HoIM 1 Test Hole # 2 <br />Parcel: Diameter: in I De the in Parcel: Diameter: in I Depth: in <br />TIME <br />PERCOLATION RATE: * to 155 min/in PERCOLATION RATE: min/in <br />RECOMMENDED SEPTIC AREA: <•-1 RECOMMENDED SEPTIC AREA: <br />TEST PERFORMED BY: ' 1/% 1 L �t � Phone `&i 1�(Iv-1 i.oQ i> Date '?�12-, L1'Z <br />TEST CERTIFIED BY: �' Phone: Date / <br />OBSERVED BY (RENS): ��'��s�z'c���ltki Phone /cl---;6 Date <br />EHD 42-03 REV 1112/09 PERC TEST RATE FORM <br />READING <br />WATER DROP <br />REFILLED <br />,TpIME <br />'3 i / <br />-:3 l <br />- <br />.� , �7 <br />cwt <br />t <br />rC/ <br />� 6 tJ <br />•� �a <br />02 a <br />P179 <br />1 <br />L 3 <br />TIME <br />PERCOLATION RATE: * to 155 min/in PERCOLATION RATE: min/in <br />RECOMMENDED SEPTIC AREA: <•-1 RECOMMENDED SEPTIC AREA: <br />TEST PERFORMED BY: ' 1/% 1 L �t � Phone `&i 1�(Iv-1 i.oQ i> Date '?�12-, L1'Z <br />TEST CERTIFIED BY: �' Phone: Date / <br />OBSERVED BY (RENS): ��'��s�z'c���ltki Phone /cl---;6 Date <br />EHD 42-03 REV 1112/09 PERC TEST RATE FORM <br />