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NOTE: PULL ALL & .AMITS (Septic, Well, etc.) MAKE L, .AIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005944 <br /> DATE RECEIVED by EHD: March 07,2006 APPL#: PA-0600120 <br /> Referral Agency STAFF CONTACT: ANTONIO SALCEDO PE : 2690 <br /> a LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: <br /> I Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 12614 N JACK TONE RD, LODI APN : 06327015 <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 /> Naof Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: ApprovalEr Denial Continuance nspecto <br /> ienature <br /> Supervisor/Lead Senior COMMENTS: <br /> lei l0 <br /> SUPERVISOR/LEAD SENIOR Approval: a <br /> ii6k9" <br /> EH 06 06 Report#7201 March 07,2006 <br />