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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 />PERCOLATION TEST RATE <br />ADDRESS OR LOCATION: �'N 'W / / / ✓�`'�• • r ' 01 ,,1 <br />CITY: <br />OWNER NAME: dA i /! /lA --- -- DATE: /7 7 z •z -- <br />�/ �� _ <br />APN: V"I -,(� l r 3 APPLICATION #: �A " 7 I ��D� / _ _ DEPTH TO FIRST WATER: r- _Ft <br />SOIL TYPE: <br />REMARKS: <br />A-wm I iUN Ur 1 t-31 HULt5 <br />�..I t .I J i. i i i_ - <br />., 1.. I .. <br />AND STRUCTURES) <br />lii?�ifitflli� ! <br />P f S l f i <br />i <br />SUIL PROFILE IF REQUIRED) <br />Depth Soil Type Depth Soil Type Depth Soil TypeDepth Soil Type Depth Soil Tyke <br />Test Hole # 1 <br />Parcel: Diameter: )2. in I De the 24 in <br />TIME <br />READING <br />WATER DROP <br />IRUILI.ED <br />32 <br />TEST CERTIFIED BY: <br />OBSERVED BY (REFIS): <br />f �a <br />/.go <br />v, zo <br />EI ID 42-03 REV 111210) <br />3,) <br />p.�� <br />Cilli <br />iII1..II:�1I.I <br />�'ry/ •A <br />� �l7� <br />A-wm I iUN Ur 1 t-31 HULt5 <br />�..I t .I J i. i i i_ - <br />., 1.. I .. <br />AND STRUCTURES) <br />lii?�ifitflli� ! <br />P f S l f i <br />i <br />SUIL PROFILE IF REQUIRED) <br />Depth Soil Type Depth Soil Type Depth Soil TypeDepth Soil Type Depth Soil Tyke <br />Test Hole # 1 <br />Parcel: Diameter: )2. in I De the 24 in <br />TIME <br />READING <br />WATER DROP <br />IRUILI.ED <br />32 <br />TEST CERTIFIED BY: <br />OBSERVED BY (REFIS): <br />f �a <br />/.go <br />v, zo <br />EI ID 42-03 REV 111210) <br />3,) <br />p.�� <br />�' 3�i <br />�'ry/ •A <br />� �l7� <br />/x:31- <br />„I �•t <br />�,U� <br />/ s_;.. <br />PERCOLATION RATE: <br />?_ minlin <br />RECOMMENDED SEPTIC AREA: <br />TEST PERFORMED BY: <br />32 <br />TEST CERTIFIED BY: <br />OBSERVED BY (REFIS): <br />I <br />....... <br />EI ID 42-03 REV 111210) <br />Test Hole # 2 <br />Parcel: Diameter: /?-. ' in I Depth: in <br />TIM@ <br />READING <br />WATER DROP <br />REFILLED <br />32 <br />�' 3�i <br />�'ry/ •A <br />� �l7� <br />/x:31- <br />„I �•t <br />�,U� <br />/ s_;.. <br />PtKGULAI-ION RATE: i=-� minlin <br />RECOMMENDED SEPTIC AREA: <br />Phone: (?�ir1 i �'.�w11 Date <br />Phone: _ Date <br />Phone Date ! r <br />PFRC 1'LS I' RAI F FORM <br />