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Q PERCOLATION TEST LOG Time:
i' Date: �,
1
Map/Lot No. Address: ((off( ('�4 �y
Engineer: 'S/71 512Qi 9 Health Agent: j'cjj-y l ,j----Expansion Area: Yes: No: Suitable/Subsurface Sewage: Yes: No: ro
IExpansion Area Tested: Yes No: Leaching Field: Pits: Trenches:
I If No, Why? Unsuitable: Why?
Well: Town .ter: Subdivision/Owner's Name: 4
SKETCH: I 6
Pr
1a.Gl. +?
Notes: !,r,� V @ V/ ' Oft L/30 Water At:/) ? t.
DEEP OBSERVATION HOLE LOG
Depth fromSurface Soil Horizon Soil Texture Soil Color Soil Motting Other
(inches) (USDA) (Structure,Stones,Boulders,
Consistency,%Gravel)
t - 1I ‘—t5 ', y(1. 3/�
f I. S /0 s/k
) r—1 C C S /1/4"4 ��
LS If 09%
a
c-/6� C j 10tilt 4 /
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{ DEEP OBSERVATION HOLE LOG
Depth fromSurface Soil Horizon Soil Texture Soil Color Soil Motting Other
(inches) (USDA) (Structure,Stones,Boulders,
Consistency,%Gravel)
A (lS IU,/,' )f)
l!, o- / o ivy,
:� cS �/�