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ROTE: PULL AL�tMITS (Septic, Well, etc.) MAK k,..,,i?IES FOR FILE <br /> LAND USE REPORT RECORD ID: 500007123 <br /> DATE RECEIVED by EHD: April 08,2008 APPL#: PA-0800003 <br /> Referral Agency STAFF CONTACT: PATRICK CROSBY PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE &SUBMIT BY: Tue, May 6, 2008 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 26151 N JACK TONE RD, GALT APN : 00723023 <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: ,�yy <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> 04 <br /> 22:03 <br /> Destroy the abandoned well taken out of service under permit number SR-80-884, <br /> under permit and inspection by a C-57 licensed well driller, or bring the well back <br /> into service as required by the San Joaquin County Development Title, <br /> Section 9-1115.5 (e). <br /> I recommend: Approval enial Continuance F Inspector: <br /> Sig <br /> Supervisor/Lead Senior COMMENTS: atu re <br /> ^X <br /> ' £ N <br /> ZZ <br /> r, <br /> It S:�AItI — — e <br /> PERVISOIt / LEAD SENIOR Approval: <� �' — �� Date. <br /> Proofread Rc o _: .. ..._,.,._.=_ <br /> =A 11 Check Off List: p:, <br /> Correct CONDITION( <br /> 111 u., <br />