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ADDRESS OR LOCATION: APN: I q r;i I mo, g <br /> OWNER: DATE: <br /> APPLICATION DEPTH TO FIRST WATER: ft SOIL TYPE: <br /> REMARKS: LI_ <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> 71, <br /> ti <br /> T <br /> 301L PROFILE(IF REQUIRED) 5)y'�� 'Y S,z <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Dept__Soil Type <br /> -EST HOLE #1 DIAMETER:, 4/ in DEPTH: �in TEST HOLE#2 DIAMETER: in DEPTH:-�lq- <br /> TmDROP E READING WATER REFILLED TIME READING DROP WATER REFILLED <br /> 5, 30 <br /> 2- <br /> ;Z,..D -70 <br /> 62. <br /> 63 Pyy 311 <br /> 5'i) 0A <br /> /� ',Aq 5 3;1- -7, qO <br /> ) f 3 jo P 13.2 Dy <br /> /A 3 lo TAq 13 ,) <br /> 1 ,1 r, 2 , <br /> 4,q 03 vy <br /> 02" <br /> L)ERCOLATION RATE: . 22 min/in PERCOLATION RATE: Anmin./in <br /> RECONINIENDED SEPT AREA: RECOATLNIENDED,SEPTIC AREA: <br /> LEST PERFORMED BY: Phone: v) -1-16 v Date 5 <br /> TEST CERTIFIED B l Phone: 326)Z Date <br /> DBSERVED BY(R-EH Phone f g-34 3 Date '51 <br /> .HD 42-02-003 P.216- 6I27.1 FERC TEST RATE FOR-Mic <br /> ,EVISED 5/7/02 <br />