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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012236 <br /> DATE RECEIVED by EIID: April 02,2019 APPL#: PA-1600200 <br /> Referral Agency STAFF CONTACT ALISA GOULART PE : 2631 <br /> S{I�j Ew,AnPPRrOV1A9L,-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Thu, April 18, 2019 1 ]t I`� L/�v` l&lbn <br /> Assigned to : EE0009488 Wl3 5< <br /> SITE ADDRESS: 15467 E KETTLEMAN LN, LODI APN : 05308020 <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: NIA Public Sewer: N� <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> 1) Exis�ng Se.�-►;c sys-�e rn SR006Z 2�1�' <br /> 2) s-ti!)s ckomesfiic uoaL, S R Oa 5 1 3-1 1 <br /> I recommend: Approval Q Denial El Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> L9 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> FQA h k ff i • Proofread Report? Correct LAND USE#? <br /> �Corcect CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 April 02.2019 <br />