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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 'f Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: //53 SouTW&oGDEN 5',a7T�: A VEplblj5_: CITY: '1To��Tdni 9So?D� <br /> OWNER NAME: DATE: <br /> APN: — O- 3 APPLICATION#: DEPTH TO FIR T WATER: SO Ft <br /> SOIL TYPE: — L! <br /> REMARKS: 'LA IQD/tJC> WA TF-fZAj�T=2 Pg r-567AA1 _ <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> ....^� <br /> I IIIII ¢ . <br /> I H I ..... _ ........... a — <br /> i r I f — i_ <br /> f4 <br /> .. <br /> . ..... <br /> ...... ..... ..... <br /> ..... ...... _... <br /> _.. _ <br /> .....­­............­ <br /> ......... <br /> ...._ ._.._ _,. t................. <br /> --------- _....._ <br /> - <br /> �........ 1 I .._ ....._. 1......... ..... i - <br /> . <br /> .._�; .:Y. �..... , <br /> _ i•..... <br /> I- <br /> -.-I T <br /> _..._.��(_..�_i �_. <br /> _ . <br /> .. �._...... _ ...... _.�............ - <br /> j <br /> �_..__.. <br /> . �— i.. ...1 E_ - <br /> I <br /> SOIL PROFILE(IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth j I S.oil......Type Depth Soil Type <br /> .......... ...... <br /> -3 - ' L <br /> _—_............................. <br /> _...._-------------...... I <br /> _ Test Hole# 1 Test Hole #2 <br /> —r—----- -. _....— __...... [7Parcel-. ;,_4 -- -- ...._._...-------- <br /> Parcel: 3 Diameter: S in Depth: in Diameter: �,S in Depth: in <br /> TIME READING WATER DROPREFILLED TIME READING ; WATER DROP REFILLED <br /> <....*V............._ -..._..... <br /> .._................... .� .......... Z�._._.............................. <br /> 2, — <br /> 3 <br /> _.._ ..__....__�... ....4.1.... _....._ _.._.-.........._......- ... . <br /> ..._._o.......3..._..._._.._............. .... ..........._.__...... <br /> • • 33 <br /> ._ ....... <br /> 1x2_..33_ 3L <br /> //__m P..P ..-11__ i ..___._............. <br /> l/...:�r..._.... 3_.3_x......._. D., , ..�......_..... .. <br /> I ; - <br /> a- / .2,0- <br /> � _ Q...� 3 <br /> _._......_t__..._ .__... _._. _..._.......__...__. <br /> PERCOLATION RATE: /a Q min/in PERCOLATION RATE: -�' min/in <br /> RECOMMENDED SEPTIC EA: S o/2?— RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: Phone: ���-q i-(GSoZ Date ,,Z 1,A 3 2d <br /> TEST CERTIFIED BY: Phone: Date <br /> OBSERVED BY(RENS): Phone 3CZ1 Date Z <br /> EHD 42-03 REV 11/2/09 <br /> PERC TEST RATE FORM <br />