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4 NOTE: PULL ALS ,ERMITS (Septic, Well, etc.) MAKE, )PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007965 <br /> DATE RECEIVED by EHD: November 02,2009 APPL#l: PA-0900263 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2659 <br /> WILLIAMSON ACT CONCELLATION <br /> COMPLETE& SUBMIT BY: Wed, November 17, 2009 (WC) <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 100 E TADDEI RD, ACAMPO APN : 01313023 <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 0 Denial F-1 Continuance Insp <br /> Sign tore <br /> Suaervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> EL1A 1!GQck Off=Lrst Prod cadTtepar� �1�T USES? <br /> w <br /> orre NI}IT ION ). _"` -' agg d at D U%F,136ok??. <br /> EH 06 06 Report 47201 November 03,2009 <br />