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o,,q"l>,r, 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 />PERCOLATION TEST RATE <br />ADDRESS OR LOCATION: <br />i53! `l urn+or Q oa� CITY: 1 °� <br />OWNER NAME: DATE; <br />APN: bas - 19 - ;k APPLICATION #: <br />SOIL TYPE: 5:11 - S"_>_ <br />REMARKS: <br />DEPTH TO FIRST WATER: Ft <br />LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br />, <br />$7 s—_� • ! c_._' <br />--� -i-- <br />WATER DROP <br />REFILLED <br />8'• sf- a. <br />,%s <br />'5.,%S- <br />4. 9S <br />4 I <br />11'. <br />q'. es o. <br />0.3 <br />a) fS• <br />R ooa <br />' <br />__t—+_ <br />!. <br />IT <br />4?c' <br />4.35 <br />ii.Ssa,. <br />l2•.,S i'" <br />c.a' <br />W -5D c-1�`► <br />S ! <br />d•3 <br />y. <br />00" <br />1 �, <br />�'3 <br />41 Li <br />11 '. y. <br />`�— <br />d.. <br />1 <br />N • s _... <br />F1 <br />F-1 <br />r <br />I l <br />l i <br />�1 ►! l i-_ <br />I� I <br />Z-71, <br />-9- <br />i <br />_! <br />_1 ��I ! <br />Pq <br />11 i lLl I � I � <br />! <br />� !---i <br />' <br />11 <br />5UIL NKUI-ILL (IF REQUIRED) <br />Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br />3' T, 11V • S�'.� 3 . (�' 5,14 5...1 <br />Test Hole # 1 �I.ti Test Hole # 2 G �s <br />Parcel: Diameter: in De the I Parcel: Diameter: in Dept : 3b in <br />TIME <br />READING <br />WATER DROP <br />REFILLED <br />8'• sf- a. <br />,%s <br />'5.,%S- <br />4. 9S <br />4 I <br />11'. <br />q'. es o. <br />0.3 <br />a) fS• <br />R ooa <br />' <br />`I f <br />03 <br />4?c' <br />4.35 <br />ii.Ssa,. <br />l2•.,S i'" <br />c.a' <br />W -5D c-1�`► <br />S ! <br />d•3 <br />y. <br />00" <br />1 �, <br />�'3 <br />41 Li <br />11 '. y. <br />`�— <br />d.. <br />1 <br />N • s _... <br />PERCOLATION RATE: min/in <br />RECOMMENDED SEPTIC AREA: <br />TEST PERFORMED BY <br />TEST CERTIFIED BY: (%+ <br />OBSERVED BY (REHS): <br />TIME <br />READING <br />WATER DROP <br />I <br />REFILLED <br />8'• sf- a. <br />,%s <br />'5.,%S- <br />4. 9S <br />4 I <br />11'. <br />q'. es o. <br />G. <br />o `I <br />0. - <br />W'•3S �« <br />4.35 <br />ii.Ssa,. <br />l2•.,S i'" <br />c.a' <br />.a <br />0.14 (,.of <br />cs.2•c.' <br />PERCOLATION RATE: 1- ._4 min/in <br />RECOMMENDED SEPTIC AREA: <br />Phone: ( o7 1-t3_I t, ? a Date <br />Phone: ;67-(Pf (p- NO LCI Date 11-X2- 70V <br />Phone <br />Date <br />EHD 42-03 REV 11/2109 30 _ 2 1 31 _ PERC TEST RATE FORM <br />0.5 "y XII 5'f. Y,7/ 5D <br />