Laserfiche WebLink
Iv <br /> BAVIROHMEWTA1 HEALTH DEPARTM&Tf <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 r-xr:(209)464-0138 We.&www.sjgov.org/ehd <br /> PERCOLATIOi� TEST RATE <br /> ADDRESS OR LOCATION: CITY: <br /> OWNER NAME: —DATE: <br /> API ?LICATION ft: DEPTH TO FIRST WATER:—Ft <br /> SOIL TYPE L <br /> REMARKS: <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> PERCOLATION TEST SKETCH <br /> PERCOLATION TEST SKETCH <br /> t <br /> 2-IN DIA.PVC PIPET <br /> 2-IN DIA.PVC PIPE/ <br /> 4-INDIA.SOIL BORING 6w 4-INDIA.SOIL BORING Li. <br /> k 011W <br /> �AJ �P R�OL T- <br /> 2-IN <br /> 4-IND <br /> REFILL HEIGHT REUPIULLHEIGHT <br /> -I f 1"Ll <br /> SOIL PROFILE IF REQUIRED) <br /> De th Soll Type Depth Soil Type Depth Soil Type Depth Soil Tvpe I Depth --1 Soil Type <br /> 'so <br /> Test[ Hole#I Test Hole 2 Pan-- In I Depth: Parcel: Diameter: in Depth:: <br /> TIME REAoiNG WATER DRDP REFILLED TwE R EA u i!j 'WATE.,--Dn,D- REFILLED <br /> 3,9"'p, <br /> 9,65 , <br /> lz —0.q'S 3 5 7 <br /> 0. 32- <br /> 77, <br /> PERCOLATION RATE: min/in PERCOLATION RATE: min/in <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: ------- Phone: Date <br /> TEST CERTIFIED BY: Phone: Date <br /> EH',;OBSERVED BY(R Phone*=�WL Date . <br /> DID 42-03 REV 1112109 PERC TEST RATE FORM <br /> 6. 13 - /5- - 3-1/ — o. 25--3,40 <br /> 13 , <br /> to. <br />