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NOTE: PULL ALIJ3,-GRMITS (Septic, Well, etc.) MAKE-.#PIES FOR FILE <br /> LA(.`IQ-66 E REPORT RECORD ID: SU0004667 <br /> DATE RECEIVED by EHD: October 18,2004 APPL#: PA-04-588(PRE-AP Pre-Application <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2632 <br /> COMPLETE&SUBMIT BY: S�. SITE APPROVAL-GENERAL(SA) <br /> a" dod Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 18754 E ST RT 26 HWY, LINDEN APN : 10517048,47& <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 oi"house, wind direction, etc.... <br /> Public Water: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> — v��,�� (Z��sd.S�_C=c'i��.c�E� .9` �S7�d�✓ ��/L��/��.Y��Y - ��-_ <br /> z d Zz as 4�y a/ <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> D '0 <br />� r <br /> SUPERVISOR/LEAD SENIOR Approval: Le� - Date: {V-Z-Alvw <br /> OA t1 ClreClk Off List: Prfread Report? ;Correct LiND USE:#T <br /> Correct-CONDITIONS)? ;. :-_ Logged,in LAND USE Boole <br /> EH 06 06 Report 97201 Page 7 October 22,2004 <br />