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PgUtN SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> .y <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ' Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> <fFOR PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: Gi�% W• CITY: 1 2 R C <br /> OWNER NAME: 6-t A�S FA 13 DATE: I Z/1 j/zb <br /> APN: ZS 3 — 2-i0 - 19 APPLICATION#: S 2O n g 3 O O(' DEPTH TO FIRST WATER: Ft <br /> SOILTYPE: S-�-b►��,. GlGfM 106t1V <br /> REMARKS: <br /> LOCATION OF TEST HOLES(SHOW WELLS AND STRUCTURES) <br /> .......__�____�t__..a, i L._.....i•__.�........._�.._�1...__-.i.._._6—.�..........1—..�......._.M__-.-_. ---....;_#-1..........gid-.—�.__1—�---t....-....1 # t f—�--.-J-4--�-- ' <br /> „- PERCOLATION TEST SKETCH I_-__ - PERCOLATION TEST SWCH <br /> d 2"Diameter PVC Pipe I 1 I 2"Diameter PVC PIPs <br /> ...... �. _._. <br /> ---I....... <br /> ...- <br /> ........... —i I - <br /> 3 Zg — ............ — <br /> 3 .Li S' _... — <br /> ........ <br /> 0.17'gravel 0.17'gravel <br /> t i I <br /> (. _.. <br /> fleRll Level: "( j" Refill Level: - <br /> - <br /> I-T..TI <br /> SOIL PROFILE(IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> 3u <br /> :1-�- <br /> Test Hole# 1 Test Hole# 2 <br /> Parcel: l I Diameter: Lj.in I Depth: 3.q57' Parcel: Diameter: in I Depth: <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> a:00 — Li. 5'I <br /> 0i: 30 > . 5-6 <br /> 10:00 7 -yq <br /> r0: 30 S .0 -5q 6 <br /> If -'00 S.0o .5'4 u .K 6 <br /> 1130 R(o SCJ 4 <br /> 1 Z-ooLt.C4 <br /> Iz:30 L{ 10' �Li5�- - <br /> I <br /> �l <br /> :0 0 . b •y <br /> F ,OLATION RATE: min/in PERCOLATION RATE: min/in <br /> RtI;oMMENDED SEPTIC AR RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY: Phone:(ZOq) 3 by-0 3-7 5- Date <br /> TEST CERTIFIED BY: Phone: Date - <br /> OBSERVED BY (REHS): _ Phone Date 2 j'7J <br /> EHD 42-03 REV 11/2/09 y PERC TEST RATE FORM <br />