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SAN JOAQUIN COUNTY <br /> 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 /> ��FORa PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: 5(1 C�A R 1Q D D1-L r Q lyE - S-E CITY: "?2A C V <br /> OWNER NAME: r:%J1--!I,' f )i`) r:;r ,!^C'f= ( t fit CDATE <br /> APQC 1�-- IVDU-�O APPLICATION#: DEPTH TO FIRST WATER: �J. Ft <br /> SOIL TYPE: 02r1.7 F.,T, y ��•= 3� <br /> REMARKS: u/L Dz111,S /-1 'Ilarz T/l <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> m -TTI--r-n- <br /> J_T <br /> SOIL PROFILE(IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Tvoe De th Soil Type <br /> D•1, ' ' f7� 1�-�. <br /> Test Hole # 1 Test Hole#2 <br /> Parcel: ,- Diameter: 4., in I Depth: 3lO in I Parcel.i3-/r/ Diameter: 4. S in I Depth: in <br /> 775,777,17-477 7.7Z cS7- OFPrtr e- 6 V 7,/05 <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> x', 00 Z•�0' p Z2• // <br /> 7. <br /> o -2 so ' „ 9: <br /> 3 9 ' r0 �- /, � // �7. o <br /> /0-, 30 . 4G / O -).44 ' /o: 3� ,7. !a ' �� " -2. o9 ' <br /> /•' 0 2.S 0. CP& 17' Z l " --- <br /> 0 . 57' 0, 84" , 54 92. <br /> 1_2:00 a 4,0 ' 0. �-34 : O�' �'�6' - <br /> PERCOLATION RATE: -35-- 7 min/in PERCOLATION RATE: 7 min/in <br /> RECOMMENDED SEPTIC AREA: SSE 9F_ 0'< RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: Phone: moi--165;), Date <br /> TEST CERTIFIED BY: Phone: Date <br /> OBSERVED BY(RENS): lr� G Phone ��°fir7�yi Date <br /> EHD 42-03 REV 11/2/09 PERC TEST RATE FORM <br />