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�'-4 f!r.�. SAN JOAQUIN COUNTY <br /> z ENVIRONMENTAL HEALTH DEPARTMENT <br /> `' 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> CC* <br /> QPERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: I I `�j CITY: <br /> OWNER NAME: + DATE: <br /> APN: _ �lJ J /p O — CJ`. APPLICATION#: �� O c.� DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: <� <br /> REMARKS: <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> Ll L <br /> IFF I I H 1 -1 1 d <br /> I ; L III III L- -1 <br /> 1 1-1 1 r-1 HFIM111 <br /> f _ _I ! _ <br /> 1 -7 , I ' ^1 �i 11 I I ! I I I ! [ TTl Itl- <br /> IFP ! <br /> SOIL PROFILE(IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> — <br /> 7b <br /> Test H le Test Hole# 2 <br /> Parcel: Diameter: in Depth.- I Parcel: Diameter: in Depth: =in <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> 12y 1•ZS <br /> !? rl Z z S 1 <br /> 2 - cos 2 1. (o <br /> Lf 2 ,20 C <br /> PERCOLATION RATE: 7 ' min/in PERCOLATION RATE: min/in <br /> "9COMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> 5T PERFORMED BY: 3//IPhone Date <br /> TEST CERTIFIED BY: A Phone Date <br /> OBSERVED BY (REHS): Phone Date <br /> EHD 42.03 REV 11/2/09 PERC TEST RATE FORM <br />