Laserfiche WebLink
ADDRESS OR LOCATION: � � ' "� APN: <br /> EI .� <br /> OWNER: DATE: �. <br /> APPLICATION #: DEPTH TO FIRST WATER: ft SOIL TYPE: �l <br /> 4 hour test 1 hour lost <br /> REMARKS: 301(12'Last Watw Drop) 101(12'Last water Drop) <br /> .i deep must be less than 30 deep must be less than 30 <br /> r Gil I©u3 LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) shallow must beless than 8oshallcwmust beless than 00 <br /> IM <br /> SOIL PROFILE (IF REQUIRED) � �( � .y�5 �er, , <br /> t Depth Soil Type Depth Soil Type Depth Soil Tye Depth Soil Type Sail Type <br /> �j <br /> TEST HOLE#1 DIAMETER: _�in DEP y in TEST HOLE#2 DIAMETER: LA rin DEPWATER <br /> TIME READING DROP REFFILLED TIREADING DROP <br /> ME REFFILLED <br /> JY \ I <br /> 1 <br /> c1P <br /> 091 <br /> 63 <br /> 11'' :5� <br /> I' F <br /> a <br /> PERCOLATION RATE___ min/in PERCOLATION RATE: 93J3 min/in <br /> RECOMMENDED SEPTIC ,REA: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: 1 Phone:�2. LAJ-5-1 1p3 Date: C'`2q ' �S <br /> � Phone: � 7 2 Date: r` <br /> TEST CERIFIED BY: �� l J � } <br /> OBSERVED BY(REHS): Phone:� l7"t'3 Date: <br /> REV 42-02-003 5/7/ 11i� � �I� �y � �/� �'�y 3� � �f r V `� �1*C TEST RATE FORlV11c <br /> r REVISED 517!02 C/ C l�fo C� <br /> EHD <br />