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SR0084012
EnvironmentalHealth
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30667
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4200/4300 - Liquid Waste/Water Well Permits
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SR0084012
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Entry Properties
Last modified
9/12/2022 4:24:22 PM
Creation date
4/27/2022 4:35:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0084012
PE
4222
STREET_NUMBER
30667
Direction
S
STREET_NAME
KOSTER
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
25532011
ENTERED_DATE
7/29/2021 12:00:00 AM
SITE_LOCATION
30667 S KOSTER RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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QpnN.r <br /> r\ <br /> ,cTili'p' <br /> ADDRESS OR LD t <br /> OWNER NAME: <br /> I SOIL TYPE. S f APPLICATION/; <br /> . � OEPTN TO FIRST WATER: P\ <br /> REMARKS!, lAl[l $r-QAO <br /> LOCATION OF TEST HOLES(SNOW WELLS AND STRUCTURES) <br /> i <br /> J-j <br /> I <br /> j <br /> 1 <br /> I L <br /> SOIL PROFILE IF REQUIRED <br /> De th Soil T e De th Soil T e De th Soil T e Depth Soil T De th Soil T e <br /> / ' <br /> s- ?• -ma <br /> I <br /> Test Hole#1 _ Test_Hot e#2 <br /> _ <br /> Parcel: // Diameter: .S in De the in Parcel: Diameter. in De the in <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> 3,64 7 <br /> O 3-lobi � — <br /> O <br /> 9: 342 gs /. 93.65' <br /> D 3 . G evr <br /> ERCOLATION RATE: _ /7 ' minlin PERCOLATION RATE: m`niin <br /> } <br /> OMMENDED SEPTIC EA: RECOMMENDED EPTIC AREA: �. <br /> PERFORMED BY: Phone: ZO2- D2- Date <br /> ERTIFIED BY: Phone: Date ` <br /> VED BY(RENS): Phone Date __- <br /> PERCTEST RATE FORM <br /> REV 112!09 <br />
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