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".!.. r SAN JOAQUIN COUNTY <br /> -ramp ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazeiton Avenue, Stockton, CA 95205-6232 <br /> Telephone:{209}468-3420 Fax: (209)464-0138 Web:wwW.sjgoU.arglehd <br /> �4�►�OR'4''� <br /> { PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: Z Z I lO 2-7- 1�-LI CITY: 1- 2 .76 <br /> OWNER NAME: l �y DATE: Z G 2 <br /> APN: - 2 APPLICATION#: (Z 7-Go lap q DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: r AV P-tDrAW <br /> REMARKS: <br /> LOCATION OF TEST HOLES SHOW WELLS AND STRUCTURES) <br /> i <br /> 3 i i 7 y <br /> FEWMATWITESTSIVU PERCOLATION TEST METCH <br /> Y 01 Itr Pw p%w 2.IDWaeW PVC Pk* <br /> 3 <br /> 'L - I <br /> G j _._..... <br /> s <br /> �- <br /> _ <br /> • ]O er praral ]air 9-fa <br /> 1 �� — <br /> ReNN Lawel: L(. 2-. NMI uva .Q — 4.Lr3 <br /> 71-1 <br /> SOIL PROFILE IF REQUIRED <br /> Depth Soil Type De th Soil Type Depth 5o11 Type De th 361 Type Depth Soil Type <br /> o - •�• sI L T- CI <br /> Test Hole #1 Test Hole #2 <br /> Parcel: Diameter: in De the Parcel: ❑iarrseter; in De the } <br /> TIME READING WATER DROP 1 REFILLED TIME READ#NG WATER DROP REFILLED <br /> 10. 00 <br /> 10,7o Lf, fo C o <br /> I ! 1 (4. o <br /> ! z: .74 . 019 4.619 r Za . z� •01 <br /> .� <br /> I - oa t4'10 11 f • 30 9-- $ . 31 <br /> 1130 L4. C --� a G 1 :40 C1.31 30 <br /> :n0 _ �- 1 l ' So 3 S 30 D 6 <br /> 2:00 <br /> PERCOLATION RATE: ...... 2 3 _mintin PERCOLATION RATE: 2• 3 minlin <br /> RECOMMENDED SEPTIC EA: RECOMMEND D SEPTIC AREA: <br /> TEST PERFORMED BY: Phone: 3�q- Q3 �Date Z <br /> TEST CERTIFIED BY: Phone: Zo`I 3G'j- 03-1 1 Date 3 - 2-- <br /> OBSERVED BY(REHS): Phone 20 -6 fg :eG) Date 7-12 _ <br /> EH 42-03 REV 1112109 PERC VEST RATE FORM <br />