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NOTE: PULL ALRMITS (Septic, Well, etc.) MAKE -PIES FOR FILE <br />LAND USE REPORT RECORD ID: SU0007159 <br />DATE RECEIVED by EHD: April 28, 2008 <br />Referral Agency STAFF CONTACT: JASON JONES <br />COMPLETE & SUBMIT BY: Tue, May 20, 2008 <br />APPL #. PA -0700523 <br />PE : 2622 <br />SUBDIVISON - MINOR (MS) <br />Assigned to : EE0005366 MEDINA <br />SITE ADDRESS- 1525 E .1AHANT RD, ACAMPO APN : 00315008 <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: L"2 � <br />Name of Purveyor Name -of System <br />SUMMARY OR COMMENTS: <br />��. 0" <br />I recommend: Approval �enial El Continuance Insctor: <br />Signature <br />StQrvisor/Lead Senior COMMENTS: <br />SUPERVISOR/ LEAD SENIOR Approval: <br />EH 06 06 Report 117201 <br />Date: [ ' / :?- Z -A <br />Apr 129, 2009 <br />