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Address: 10800 West Ripon Road, Manteca <br />!t <br />h <br />3t�15A <br />ADDRESS OR LOCATION: <br />OWNER NAME: <br />SOIL TYPE: $1�. <br />REMARKS: <br />1 EN� <br />i'mC[�OCC'��'� <br />1E <br />I'��iiti!��■ <br />188 `Kort 5-6232 <br />Telephone: (209) 468-3420 Fax (208) 484-0138 Web: www.eigov.orglehd <br />PERCOLATION TEST RATE <br />. ll, <br />7■ <br />r■ <br />cln: <br />1 Parcel: Diameter. In I Depft In <br />■■ <br />D Bdp APPLICATION N; <br />DEPTH TO FIRST WATER' <br />ID: SR0058019 <br />■■ <br />■ ■-... <br />■ <br />i'mC[�OCC'��'� <br />1E <br />I'��iiti!��■ <br />Test Hole 1 <br />■ ■ ■QUICA■■■ ■■ai <br />MINE <br />. ll, <br />7■ <br />r■ <br />Diameter: in I Depth: In <br />1 Parcel: Diameter. In I Depft In <br />■■ <br />■ <br />Elm <br />■■■ <br />■■ t <br />■ <br />PERCOLATION RATE: _ <br />RECOMMENDED SEPTIC <br />TEST PERFORMED BY: _ <br />TEST CERTIFIED BY: <br />OBSERVED BYM(REHS)`. <br />minim PERCOLATION RATE: <br />_. <br />Test Hole 1 <br />Test Hole # 2 <br />1 <br />ParoeF. <br />Diameter: in I Depth: In <br />1 Parcel: Diameter. In I Depft In <br />PERC <br />TIME <br />i <br />READING WATER DROP REFILLED <br />TIME READING WATER DROP REFILLED <br />adE� <br />3 <br />#3 <br />$IO <br />D <br />PERCOLATION RATE: _ <br />RECOMMENDED SEPTIC <br />TEST PERFORMED BY: _ <br />TEST CERTIFIED BY: <br />OBSERVED BYM(REHS)`. <br />minim PERCOLATION RATE: <br />RECO14MENDED SEPTICAREA: <br />Phone: �lbo & Date <br />Phone: <br />Date <br />+� <br />Date <br />PERC <br />Naseem Ahmed, Registered Environmental Health Specialist <br />