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NOTE: PULL ALL .-,RMITS (Septic, Well, etc.) MAKE .-.,.PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004682 <br /> DATE RECEIVED by EHD: October 21,2004 APPL#: PA-04-623 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, November 16, 2004 <br /> Assigned to : EE0001456 HESS <br /> SITE ADDRESS: 13039 S ST RT 99 W FRONTAGE RD, MANTECA APN : 20405029,44 <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 /> << - O sJ C <br /> Pc, o l <br /> I recommend: Approval I Denial Continuance F] Inspector: <br /> /I Signature Supervisor/Lead Senior COMMENTS: <br /> .01 <br /> 40 <br /> G — a2 <br /> f <br /> SUPERVISOR/ LEAD SENIOR Approval: I.��-�-� Date: <br /> OA li Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Pagc 22 October 22,2004 <br />