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NOTE: PULL AL <br /> C E-`�RMITS (Septic, Well, etc.) NIAKEPIES FOR FILE <br /> LAND USE REPORT RECOR : SU0008040 <br /> DATE RECEIVED by EHD: December 23,2009 APPL#: PA-0400280 RE <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE ; 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE & SUBMIT BY: Tue, January 19, 2010 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 17641 E FRENCH CAMP RD, RIPON APN : 20322021 <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: ,-rI Public Sewers'^ <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> LJ jo 4e <br /> I recommend: Approval /Denial Continuance Inspecto <br /> ignature <br /> S_ upervisor/Lead Senior COMMENTS: <br /> r / � <br /> SUPERVISOR/LEAD SENIOR Approval: Date: L-)7-0 <br /> OA 0f Check Off J. r PFot�i ead i port Cariect t ANI1 f3 <br /> E~arseeY CONDITiON "L 11D USE,Boob <br /> EH 06 06 Report 47201 December 29,2009 <br /> it <br />