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NOTE: PULL ALLk._.RMITS (Septic, Well, etc,) MAKt'_;PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004639 <br /> DATE RECEIVED by EHD: September 21,2004 APPL#: PA-04-536 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2690 <br /> EAT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: <br /> Assigned to : EF-0000018 TRINDADE <br /> SITE ADDRESS: 16101 S MURPHY RD, ESCALON APN : 20311015& 16 <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: ApprovalEr Denial F-1 Continuance Inspector <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> s <br /> ff <br /> r <br /> OIL- <br /> - u v <br /> I' <br /> � r <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA!l Ghecli Off List: - Proofreaort' LAID-USE# <br /> d.Rc " <br /> 4., . Correct CONDI 1Loggeiti AND tl $oZ__ <br /> EH 06 06 Report#7201 Page 3 September 29,2004 <br />