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NOTE: PULL ALLY-.,RMITS (Septic, Well, etc.) MAKE --.rP1ES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004483 <br /> DATE RECEIVED by EHD: May 20,2004 APPL#: PA-04-253 Pre-Application <br /> Referral Agency STAFF CONTACT: CHANDLER MARTIN PE : 2691 <br /> GEN PLAN AMENDMENT 10+acres(GP) <br /> COMPLETE& SUBMIT BY: Wed, June 9, 2004 Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 6125 E QUASHNICK RD, STOCKTON APN <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: Approval Denial Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> XA4� - <br /> T C Z - <br /> ' 0 <br /> <' � o : DSraI <br /> Ah <br /> vp <br /> SUPERVISOR/LPAD SENIOR Approval: Date: <br /> OA II Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Pagc 7 r d4"O' a 2004-r'i <br /> z S <br />