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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012200 <br /> DATE RECEIVED by EHD: March 22,2019 APPL#: PA-1600179 <br /> Referral Agency STAFF CONTACT: TEDDIE HERNANDEZ PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Thu, April 18, 2019 Time Fl)ctmim <br /> Assigned to : EE0009488 WONG r) <br /> SITE ADDRESS: 7871 E HWY 12 , LODI APN : 05135007,05135008 <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: Nokie, Public Sewer: /V0 <br /> Name of Purveyor Q Name of System <br /> SUMMARY OR COMMENTS: I.A. FW (�✓) 'O QU{1 r <br /> A Ae. res . A VWWAA445 SkM iO4a,11a ;0 liel 12 I gew <br /> U 6 ,c r ✓) <br /> Q D�vlk1s x- <br /> c.� <br /> D e ori <br /> 1 recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> 44 9 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 2 <br /> OA 11 Check ff List., Proofread Report? V Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> LI 106 06 Report 47201 March 25,2019 <br />