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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011813 <br /> DATE RECEIVED by EHD: June 08,2018 APPL#: PA-1600128 <br /> Referral Agency STAFF CONTACT ALISA GOULART PE : 2631 <br /> SITE APPRQVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Fri, June 15, 2018 Kvis <br /> Assigned to : EE0009488 WONG <br /> SITE ADDRESS: 16123 N LOCUST TREE RD, LODI APN: 05113069 <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: Nev.� Public Sewer: A)v ti2 <br /> Name of Purveyor 04. 2 Name of System <br /> SUMMARY OR COMMENTS: �12L'Ul' o 6k V( y&- u 14 �A,r' <br /> Or <br /> '�" JS 4 7n IS} 70 >+i�dvn n9rr ,v �S l�" ea� Wl a`r Y�Inas <br /> V-3cPml bJ H-1 -G r `✓ /G-wel raO. r " <br /> �I6VI� YAW1 Jf,161 l0 VY\21— S1� (V Z VAAAja5 Z11" <br /> xa,w a ro -Ca' fAo-'rs . <br /> I recommend: Approval ❑ Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> G <br /> G—' <br /> c <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA H Check Off Li • Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 June 11,2018 <br />