Laserfiche WebLink
_ °: ID <br /> o, O rD D <br /> D pb 0- <br /> N <br /> o st <br /> �' Ln <br /> (D N H <br /> O) �r.A4ilry <br /> c SAN JOAQUIN COUNTY I–' <br /> —..F. i n O <br /> F., J <br /> a ENVIRONMENTAL HEALTH DEPARTMENT O_ �p O <br /> M 1868 East Hazelton Avenue,Stockton,CA 95205-6232 Cn <br /> < r � Telephone:(209)468-3420 Fax:(209)464-0138 Wei):www sigov.orglehd W <br /> iil F..Ft�,�`, <br /> O <O oa n <br /> PERCOLATION TEST RATE 3� ,rt <br /> ADDRESS OR LOCATION: ��. .I <br /> O <br /> ! rCITY: N (A <br /> (D OWNER NAME: 1._ .DtP�/N�f <br /> DATE: C-;;-�l'! _._... N D <br /> SOIL TYPE <br /> - -/ APPLICATION M: d �'• G <br /> SOIL TYPE DEPTH TO FIRST WATER:Li ) _pl rD <br /> = REMARKS: M Q <br /> rD <br /> CL <br /> cn LOCATION OF TEST HOLES(seoW WELLS AND STRUCTURES) (D <br /> no <br /> RL <br /> T ID In F f_� F-0 rO-I CO 10 IT <br /> - —1 —(—I —r I-•r�'• 7 --r— <br /> SOIL PROFILE(IF REQUIRED) <br /> De th Soil Type Depth Soil Type De th Soil T Depth Soil T e De ih Soil T e <br /> I <br /> I <br /> i <br /> Test Hole#1 Test Hole#2 <br /> Parcel: Diameter. in De the l' in Parcel: Diameter: <br /> in De the in <br /> TIME READING WATER DROP REFILLEDTIME READING WATER DROP REFILLED <br /> 00 n <br /> C, vel <br /> -73" <br /> �a' ?3 <br /> o $l ,Obf <br /> 00 <br /> o Od <br /> minlin <br /> PERCOLATION RATE: minlin PERCOLATION RATE: <br /> RECOMMENDED SEPTIC AREA:Date <br /> RECOMMENDED SEPTIC AEA: phone: <br /> TEST PERFORMED BY: Date <br /> Phone:�— D <br /> TEST CERTIFIED BY: _ Date <br /> Phone PE <br /> RC TEST RgTE FORM <br /> OBSERVED BY(RENS): <br /> EHD 42-03 REV 11!2109 <br /> r) <br /> O <br /> CL <br /> V) <br /> 0 <br /> O <br /> DO O <br /> rD 00 <br /> O W <br /> 0 <br />