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NOTE: PULL AL RMITS (Septic, Well, etc.) MAK PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004756 <br /> DATE RECEIVED by EHD: December 21,2004 APPL#: PA-04-768 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2632 <br /> COMPLETE&SUBMIT BY: Am . I//Cl/ ,x(',005 SITE APPROVAL-GENERAL(SA) <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 3827 N NEWTON RD, STOCKTON APN: 13207009 <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 /> -�/LC�.Z�E3�l� ' .�f�9S/��/•-�wil ��tsfi5 siTitil�y/,t�s <br /> • 7JY�/�/LGiiO�?y r'��J� G�VLlPC�� GcclrC�svB) GLEi7 <br /> I recommend: Approval F2 Denial El Continuance ❑ Inspecto <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> L <br /> IJ11 , 7 0, 07 llom -4 e <br /> SUPERVISOR/LEAD SENIOR Approval: Date: (l S <br /> OA 11 Check OB List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 5 December 27,2004 <br />