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NOTE: PULL ALL !RMITS (Septic, Well, etc.) MAKE7 PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005734 <br /> DATE RECEIVED by EHD: October 26,2005 APDL 9: PA-0500708 <br /> Referral Agency STAFF CONTACT: CEALY LEIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Ups ffpYRA 1§�Z ; <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 3304 S ST RT 99 , STOCKTON APN : 17908202 <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 /> .4 <br /> v <br /> 0t t <br /> I recommend: Approval F Denial ❑ Continuance Insp-cst <br /> Si na <br /> Supervisor/Lead Senior COMMENTS: <br /> C/ <br /> C v3 <br /> 2 <br /> SUPERVISOR/LEAD SENIOR Approval: <br /> EH 06 06 Report#7201 October 27,2005 <br />