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ADDRESS ��2 �� �11 I�YehVle & e(D �&PA# <br /> APN SU# sly"2lnb12��1 <br /> PERC TEST PARCEL Perc DEPTH PERC RATE <br /> DATE OR LOT# Hole# (feet) (min/inch) COMMENTS(PASS/FAIL) <br /> r) <br /> Myn fief <br /> y <br /> J <br /> i <br /> DATE SAMPLED TYPE OF WELL NITRATE mg/L DBCP ug/L EDB uglL COMMENTS(other address for well sampled) <br /> Mgrc m,Z Or1'1GS1'i� % vm � N� <br /> NITRATE LOADING <br /> RESULT(mg/L-N) l�j,I l L-N SU #: SU SU Date: <br />