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,22u' SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> hum600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> gLfFo��� <br /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: /V I c5: ! /�`l�� I / CITY: <br /> OWNERNAME: K U,5i-AK,4AI CdRfl DATE: <br /> APN: I�,3 "-2')d APPLICATION#: iP,114 i'7% DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE. <br /> REMARKS: <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> PERCOLATION TEST SKETCH �_. _.. I i PERCOLATION TEST SKETCH ;_- <br /> 1 i..........: _ ` t <br /> I 2-IN DIA.PVC PIPE/ ! —p 4— r� 2-IN DIA.PVC PIPE/ - <br /> 4-IN DI.A.SOIL BORING 4-IN DI.A.SOIL BORING <br /> FSd __ ? . <br /> ........... <br /> 3 7q <br /> REFILL HEIGHT '39 REFILL HEIGHT <br /> SOIL PROFILE IF REQUIRED <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> Test Hole#1 Test Hole# 2 <br /> Parcel: % Diameter: in I Depth: 3 t` Parcel: Diameter: 4 in I Depth: 3 ti c <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> x.001y - 3. 3 vS DAA 3301 <br /> 00 o)C' q f0 it 0f J <br /> I %6 <br /> rI ' 'O14 14, – c � 4� <br /> i I , :4 <br /> 3. l�- 6�-f 3 cY <br /> PERCOLATION RATE: min/in PERCOLATION RATE: _ �Cfmin/in <br /> 'COMMENDED SEPTIC AREA: ____________ RECOMMENDED SEPTIC AREA: <br /> _ST PERFORMED BY: V i Lc' Phone: --40,9_X09-3l SO Date <br /> TEST CERTIFIED BY: Phone: 2o'j_-3;?-°J_0 iq k Date 97_ ------ <br /> OBSERVED BY (REHS): __+� Phone Z�"l� �f_�(�J'( Date !����f� <br /> EHD 42-03 REV 1112/09 PERC TEST RATE FORM <br />