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NOTE: PULL ALC"RMITS (Septic, Well, etc.) MAKE L76PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006220 <br /> DATE RECEIVED by EHD: August 22,2006 APPL#: PA-0300116 TE <br /> Referral Agency STAFF CONTACT: ANTONIO SALCEDO PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE& SUBMIT BY: Tue, September 5, 2006 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 11515 W LARCH RD, TRACY APN : 21218028 <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 /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval 0 Denial ElContinuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> � Z <br /> t E <br /> SUPERVISOR/LEAD SENIOR Approval: Date: S' <br /> EH 06 06 Report 47201 August 25,2006 <br />