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0'.ix SAN JOAQUIN COUNTY <br /> �= � ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 952175-6232 <br /> " Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> rF��a PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: 19-1 E7. F(2-A-L c►Z iZb CITY: L I iNjDE-PJ <br /> OWNER NAME: 12AQa M ftRS'rb Kj ¢r DATE: Zr3 23 <br /> APN: 6(O - 19 o ` 1-2- PLICATION#: ��D p t]�� DEPTH TO FIRST WATER: T Ft <br /> SOIL TYPE: C elt,er - CovLe tAct,1Iy p r.% <br /> REMARKS: <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> PERCOLATION TEST S10:TCH PERCOLATION TEST SKETCH <br /> 2"fNamesw PVC Pipe 2.Diameter PVC Pipe <br /> ...........__ } .............. <br /> 0.17'gravel — <br /> 0.17'gravel <br /> Refill Level: 1 D ...... <br /> Refill Level: <br /> SOIL PROFILE (IF REQUIRED) <br /> Depth Soii T e De th Soil Type Depth Soil Type Depth Soil T e Depth Soil Type <br /> S 3'-3.3 <br /> Test Hole # 1 Test Hole # 2 <br /> PameFj Diameter: L{ in Depth: 3.3 ' Parcel: Diameter: in De the <br /> TIME READING WATER DROP REFILLED TIIUE READING1 WATER DROP REFILLED <br /> (6,1010 ve V 7.414 <br /> 10%30 Dr �.�S .d3 <br /> 11 :00 .b k.Db <br /> li:3o .s� q.7 <br /> ii Z.0D �{. Q q. �5 <br /> 17-1. 30 .G . 51 K•0} <br /> 1,100 -�o . 53 1{ .ILI <br /> L4 . I G <br /> Z'dt] <br /> PERCOLATION RATE: 5.Cl 3 minlin PERCOLATION RATE: minlin <br /> RECOMMENDED SEPTIC A E RECOMMENDED SEPTIC AREA: <br /> TEST PERFORMED BY; Phone: 20i �;a4_p37C_ Date 32-3 <br /> TEST CERTIFIED BY: A Phone: _`Z-e� 3j -o3-1 Date Z -_ --_3 <br /> ( ): Pho 1_ <br /> OBSERVED 8Y REHS one Date � Z 3 <br /> EHD 42-03 REV 1112109 PERC TEST RATE FORM <br />