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S` ANN= ,*_ PERCOLATION TEST LOG z Time: /r/
i Date: (-77—d
I t Map/Lot No. 6 Vee Address: -4 (20,4 ek,we
i Engineer: 4 , Q'O!/f Health Agent: //✓i'`f ----
ExpAnsion Area: Yes: No: Suitable/Subsurface Sewage: Yes: No:
Expansion Area Tested: Yes No: Leaching Field: Pits: Trenches: 1
If No, Why? Unsuitable: Why? I
4
I
Well: Town Water: Subdivision/Owner's Name: t
1
SKETCH: ;
11111,
`l
Notes: ,,Z....1,'/ ihAe0 ' Water At: ! Fl.
DEEP OBSERVATION HOLE LOG
Deptic$old. urface Soil Horizon Soil Texture Soil Color Soil Molting Other
(inches) (USDA) (sttucttn-,stuns,Boulders,
Consistency,%Gravel)
LS /,'XI / tee-6e wit
(P
f 0 � L Y44
cam)
t, ,(#0 - M> C /6 /I) l
I
DEEP OBSERVATION HOLE LOG - ---
Depth fromSurface Soil Horizon Soil Texture Soil Color Soil Motting Other
(inches) (USDA) (Structure,Stones,Boulders,
Consistency,%Gravel)
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