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� o <br /> v� <br /> D <br /> O Q <br /> CNV NTAL fi P,5i7­iorJ 1„� <br /> O sJ�a Telephoner(8 09)468-3420 Fax:209)4668 East Hazelton Avenue.4-01138StockC011 www s19 otg/ehd <br /> 7r M N 1-1 <br /> PERCOLATION TEST RATE n ON O <br /> al n�, q�/ O O M <br /> ADDRESS OR LOCATION: f�&7q 4i(g / � <br /> M rl4}Zoi ��IrJG{fo1�5� �CSFt�rl <br /> 7 OWNER NAME:__ATITUDE �j J p rERS CRY: r+ <br /> APN: 2-06 OB OD U G Intl n F(zhNZ1A'DATE: /•ZZ•ZO20 C = <br /> '1' APPLICATION#: /P 00�•0290 DEPTH TO FIRST WATER: _F� <br /> O SOIL TYPE ee (J C� <br /> REMARKS: <br /> rD rF N <br /> N O <br /> m <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> M In <br /> �;�ETrktkh�T (° <br /> v o <br /> zT <br /> ra_`-'rkri�' <br /> IETIT_T T ; - r <br /> RL <br /> i I-�, <br /> iT1-ham l I i_ 97�7 i f T 1T <br /> idflTif_H1 F_� <br /> T _ Ti-; n ,- <br /> SOIL PROFILE(IF REQUIRED) <br /> De th Soil T e Depth Soil T e De th Soil Type Depth Soil-Type I Depth Soil T e <br /> _ Test Hole#1 __ _ Test Hole#__2 _ <br /> Parcel: Diameter: in De th — — - <br /> p � in Parcel: Diameter: in De the in <br /> TIME I READING_ WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> R: 3 25` 425" +0 3 _ I — <br /> 1 o:►b 313' 4 0" -I-o 3i'Z" _. — <br /> 10:4!0 <br /> II : (0 38'8" IZy" 433 II <br /> I l :ib I 37" 4.0" -6 <br /> 12 4l0 .25" <br /> 16 3"I.12S" <br /> l :4ro 3 .75" '7� 5�� - - <br /> PERCOLATION RATE: 10.9 min/in PERCOLATION RATE: min/in <br /> RECOMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: SicFfMl� PAQmAT.I Phone: Date 1.2-7•Za717 <br /> TEST CERTIFIED BY: Phone: Date <br /> OBSERVED BY(REHS):_: Phone Date Z ZDz <br /> EHD 4213 REV 1112109 PERC TEST RATE FORM <br /> ,O <br /> rD <br /> O <br /> Q <br /> l7 <br /> In <br /> x <br /> O <br /> O <br /> 00 <br /> D) N <br /> Oro 01 <br /> rD Ol <br /> N � <br /> O <br /> N <br />