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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00011787 <br /> DATE RECEIVED by EHD: May 01,2018 APPL#: PA-1800093 <br /> Referral Agency STAFF CONTACT: ALISA GOULART PE : 2631 Plus <br /> SITE APPROVAL-MINOR(S <br /> COMPLETE& SUBMIT BY: Tue, May 22, 2078 <br /> Assigned to : EE0009488 WONG 1 yi <br /> SITE ADDRESS: 21600 N DAVIS RD, LODI APN : 01308043 39 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage disposal, water su <br /> etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population densit/Yoc <br /> of house, wind direction, eNau, <br /> q rn <br /> Public Water: Public Sewer: rU`i/ reel-Mwoc= <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: 914 —odYV✓A/61 n0 <br /> c�dr�ss vn A-FN - � D -35 f <br /> tc% ' <br /> I recommend: Approval ❑ Denial ❑ Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> z <br /> v <br /> r <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 May 02,2018 <br />