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ADDRESS 0 Ob � ZD � � PA # <br />APN Zih O - � SU# <br />PERC TEST PARCEL Perc DEPTH PERC RATE <br />DATE OR LOT # Hole # (feet) (min/inch) COMMENTS (PASS/FAIL) <br />1 AQ ih'L6Z <br />kA J- <br />, <br />DATE SAMPLED TYPE OF WELL NITRATE mg/L DBCP ug/L EDB ug/L COMMENTS (other address for well sampled) <br />NITRATE LOADING—� <br />RESULT (mg/L - N) 1' \ SR #: SR Ilk � �-- SR Date: ��� <br />