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m <br />00 <br />0 <br />0 <br />�I <br />VA <br />A <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: %702 —A -7T LA 61 CITY: <br />OWNER NAME: _f/}1R/Y%A/JD (J A ✓OLA DATE: -'70 802.2 <br />APN: �97i 'r2 r/O�� I APPLICATION #: DEPTH TO FIRST WATER: Ft <br />SOIL TYPE: Si,E RI: f�O2T (-4p <br />REMARKS: NO 5-r--AtJoi/J1 NATLf- f�l 't <br />m■ ■■ ■■ ■■ ■■ ■ No No ■■■ ■■ ■■ ■■ ■■ ■ <br />...m..C■■m..m.� .....m.■.m..m..m ... ■ <br />..�.. ....... .■ ..0■C■...■■■■■m■■m:. ■■m <br />■■■■■m■■■■■■■mm■■ ■■■■■■■■■■■■■■ ■■ ■■■■■ <br />■■■.■■■■■■ ■■■■■■■■■■■■■■■■■■■�■■■■ <br />.■.■. ■■.....�..........m..m.■m..m...... <br />.■.■■......... .. ■.MEN ■■.■■.l!. ............ ...... <br />SOIL PROFILE IIF REQUIRED) <br />De th Soil Type Depth Soil T e De th Soil T e De th Soil T De th Soil T e <br />Test Hole # 1 Test Hole # 2 <br />Parcel' Q 1 1 Diameter S in Depth: 3 (o In Parcel �i l Diameter: S in Depth: jG in <br />TIME <br />WATER DROP <br />NFA <br />/®m <br />ii <br />PERCOLAIIUN KAIt: ...... <br />RECOMMENDED SEPTIC EA: F 2 <br />TEST PERFORMED BY: <br />TEST CERTIFIED BY: <br />OBSERVED BY (RENS): f �� ncti3 <br />EHD 4203 REV 112/09 <br />PERCOLATIUN KA i t: <br />RECOMMENDED PEPTIC AREA: <br />Phone: a/ - D - LS Date 9 ¢d 20 <br />Phone: Date <br />Phone n0R_ 6 l b- 3(7111 Date ` ! z0 -7_ z <br />PERC TEST RATE FORM <br />T <br />2 <br />NFA <br />/®m <br />ii <br />PERCOLATIUN KA i t: <br />RECOMMENDED PEPTIC AREA: <br />Phone: a/ - D - LS Date 9 ¢d 20 <br />Phone: Date <br />Phone n0R_ 6 l b- 3(7111 Date ` ! z0 -7_ z <br />PERC TEST RATE FORM <br />T <br />2 <br />