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PERCOLATION TEST LOG Time: /" ;
Date:
Map/Lot No. 14 t A Address: 5a E)65 ea rC) s
Rn&ear: 1)C4A420. M Health Agent: 94 / i— T CI5C,11
t Expansion Area Yes: No: _ Svitable/Subsinface Sewage: Yes: No: f
Expansion Area Tested: Yes No: Leaching Field: Pits: Trenches: i
If No, Why? Unsuitable: Why?
Well: Town W. a . 5 Subdivision/Owner's Name: t
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D k:NP OBSERVATION HOLE LOG
Depth fromSurface Soil Horizon Soil Tcwre Soil Color Sail Molting, I ( Other(Inches) (USDA) Grant)Grant)t
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DEEP OBSERVATION HOLE LOG
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