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NOTE: PULL ALL r .EMITS (Septic, Well, etc.) MAKE SPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004506 <br /> DATE RECEIVED by EHD: June 09,2004 APPL#: MS-01-8 <br /> IIIA <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 262 <br /> SURDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, July 6, 2004 Assigned to : F-EO000149 BORGES <br /> SITE ADDRESS: 27475 S FAIROAKS RD, TRACY APN : 24811033 <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.... <br /> Public Water: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR 1 LEAD SENIOR Approval: Date: <br /> OA It Check OfFList. <br /> Proofread Report?. <br /> Correct- AND USE# <br /> `Correct CONDITION{S) ogge" 1n LANA USE6k° h.,. <br /> EH 06 06 Report#7201 Page 4 June 21,2004 <br />