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PgUlry SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Q: <br /> W, ` 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> 9L/FORS <br /> PERCOLATION TEST RATE <br /> 2-140'1 ADDRESS OR LOCATION: J COY-1-G.d �y�( OW '�lil CITY: r"-&N Q'�30 9 <br /> OWNER NAME: f� YL(�✓' <br /> - Kgh t'o In DATE: I0112jZZO7,0 <br /> APN: �i!Z_ ?�6O - OZ APPLICATION#: S(ZV 0 `�'�h DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: G4fq <br /> REMARKS: <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> ............ 3 .i—..... .....L— i — f-_E—l_.......1 - +_ —f i 3 •—� —L i—,— —� i <br /> PERCOLATION TEST SKETCH ? ° PERCOLATION TEST SKETCH <br /> _..._. ..._...—l ......_.I �._ <br /> 2"Diameter PVC Pipe I I 2"Diameter PVC Pipe <br /> 3 z5 <br /> k . ......... <br /> 0.17'gravel 10.1T gravel <br /> . _ <br /> a i <br /> — / ._......:__ <br /> Refill Level: 2-1 <br /> 0 - `t� - Refill Level: � <br /> I ( I f <br /> SOIL PROFILE(IF REQUIRED) <br /> Depth Soil T e Depth Soil Type Depth Soil T th e De Soil T e Depth Soil T e <br /> 0 .25' r s <br /> ,15- 3.y Z' s: <br /> Test Hole # 1 F Test Hole # 2 <br /> Parcel: I Diameter: y in I Depth: lcc�z Parcel: Diameter: in I Depth'. <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> p Dfb -- Y. 3l <br /> 3b x-16 . IS t4.30 <br /> 10. 00 Lf,q0 Jo Lf ,.3I <br /> 10. 3 0 'i 3C4Lf -3q <br /> 0 t I <br /> tI 30 `1. 31 , 0 :;1- .z6 <br /> 1 Z 00 q. S3 07 <br /> 12:30 32 07 q, `d <br /> 00 -1 .31 ,06 <br /> F :OLATION RATE: 41, :f min/in PERCOLATION RATE: min/in <br /> RL__OMMENDED SEPTIC AREA: RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: Phone:(-,70q) '50 0 3:15- Date (01!7-17--o <br /> TEST CERTIFIED BY: Phone: `► 3 2_9 `° `t Date 10- T - 2­b <br /> OBSERVED BY (RENS): Phone 61 o Date » <br /> EHD 42-03 REV 11/2/09 PERC TEST RATE FORM <br />