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NOTE: PULL ALL-eERMITS (Septic, Well, etc.) MAKE''WOPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0003636 <br /> DATE RECEIVED by EHD: May 04,2004 APPL#: PA-04-217 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2660 <br /> DEVIATION(DV) <br /> COMPLETE&SUBMIT BY:_,F� / � t� Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 16426 S STEINEGUL RD, ESCALON APN : 22912027 <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 F-1 Denial F-1 Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 6 May 10,2004 <br />