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PQUIN SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> a� Z< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> •' '' Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> cc'9C/•FpR�`P <br /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: )2 1 2-3 E- - H-w`I' Z'(v CITY: S7bt�C fad <br /> OWNERNAME: S0P[-VC I-1-EjZ^'Pf►1jDEZ DATE: <br /> APN: os- 11 - 0 -1 9 APPLICATION#: Sk00V;2-5-I _DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: C G bvv IN L-b FyvY\ ZT-iN PLO n C L/rj C o/t v^ <br /> REMARKS: <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> PERCOLATION TEST SKETCH ., PERCOLATION TEST SKETCH <br /> 2"Diameter PVC Pipe 2"Diameter PVC Pipe <br /> � 5 s <br /> --.......... Z <br /> 0.17'gravel ! 0.17'gravel ....-. <br /> -1 lam(/ . 6 I € <br /> Refill Level: (4 .3 - Refill Level: <br /> i <br /> i I <br /> SOIL PROFILE (IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type De th Soil Type Depth Soil Type <br /> - I <br /> 12.'—2.44' r:It <br /> Test Hole # 1 Test Hole # 2 <br /> Parcel Diameter: in Depth: 2--t4CII Parcel: Diameter: in De the <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> i0:oo Rry 4.IQ - <br /> 10:30 4- N 6 q. 19 <br /> --TP—.o 0 '4. 57( .32- Li. 15 <br /> 11: 30 .46 {.7-1 <br /> 12:30 4.u3 I6 <br /> t:0 0 L{.4r S 4.1'-+ <br /> I:30 t!D *3 <br /> PERCOLATION RATE: t0.0 min/in PERCOLATION RATE: min/in <br /> RECOMMENDED SEPTICEA: RECOM ENDED SEPTIC AREA: <br /> TEST PERFORMED BY: � Phone: (ZM 3Gq—o3:'S Date <br /> TEST CERTIFIED BY: Phone: Zo y 30- o-5-7!T Date S-I I-az <br /> OBSERVED BY (REHS): <br /> P h o n UOQ Date <br /> EHD 42-03 REV 11/2/09 PERC TEST RATE FORM <br />