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> pA� 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 C <br /> ADDRESS OR LOCATION: // L� ' �� R1v J' CITY: <br /> OWNER NAME: IWI/ Imti /7C . DATE: iC 31 <br /> APN: G4O - APPLICATION M skod SY a0 DEPTH TO FIRST WATER: Ft <br /> SOIL TYPE: C l i.✓ 4r l 4 _ <br /> REMARKS: ikic I <br /> 51�- <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> 3. ! _ _ F 1 F1 I, . <br /> 1 I-f-T-jJ-i i I 1 I i i [-1 i rl_ I R i <br /> - LLI L L r1 1I <br /> SOIL PROFILE IF REQUIRED <br /> Depth Soil Type Depth Soil TvDe Depth Soil Type Depth Soil Type Depth Soil Tye_ <br /> Test Hole# 1 Test Hole#2 <br /> Parcel: Diameter: in I Depth: Parcel: Diameter: in I Depth: in <br /> TIME READING WATER DROP REFILLED TIME READING WATER DROP REFILLED <br /> `719. � <br /> aS l. b G,vo <br /> 55 q.of o o/ <br /> /vim C/. 102 0 . of <br /> /055 �,Q9- �• �� <br /> zr q,o¢ �• � <br /> 1/ 55 D o ,n/ <br /> 12 z6 <br /> ILLS e .p d ,o= <br /> PERCOLATION RATE: 0 min/in PERCOLATION RATE: minlin <br /> RECOMMENDED SEPTIC�ATR-EA: RECOM ENDED SEPTIC AREA: <br /> TEST PERFORMED BY: Id&W L2jZ �4-An Phone �)�' 1 -993�a Date j;13i /q <br /> TEST CERTIFIED BY: Phone: Date <br /> OBSERVEDBY(REHS): Phone Date I� <br /> EHD 42-03 REV 1112/09 <br /> PERC TEST RATE FORM <br />