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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012101 <br /> DATE RECEIVED by EHD: January 14,2019 APPL#: PA-1800318, <br /> Referral Agency STAFF CONTACT? CHRISTINE LUCKASEN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Thu, January 31, 2019 <br /> Assigned to : EE0009488 WONG <br /> SITE ADDRESS: 12080 E ACAMPO RD,ACAMPO APN : 01727012 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage disposal, water <br /> supplies, etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population <br /> density, location of house, wind direction, etc.... 1 b q( ache S <br /> Public Water: P ay\-gl Public Sewer: _ <br /> Napic of Purveyor Name of System �e r <br /> SUMMARY OR COMMENTS:ZfV0.. ` n �►/� �i �'r <br /> tL <br /> � 1 • <br /> IA <br /> EROS{'?r <br /> -- f' ts PPt <br /> I recommend: Approval ❑ Denial Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> A II Check Off List. Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 January 15,2019 <br />