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NOTE: PULL ALL'v--dRMITS (Septic, Well, etc.) MAKE <,JP1ES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0003414 <br /> DATE RECEIVED by EHD: April 06,2004 APPL#: PA-04-139 <br /> Referral Agency STAFF CONTACT: JOSE RUBIANES PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: G/' <br /> Assigned to : EE0001456 HESS <br /> SITE ADDRESS: 2128 E TENTH ST, STOCKTON APN : 17121011 <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: �' f�c, S�-woof � � Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: © I <br /> C� <br /> A&Z <br /> ^4.v <br /> l l I I S S C n- AAn.a� %rte c :�t.�.� , n�l� D r- ✓�a �s� ...r r�� <br /> I recommend: Approval F-1 Denial 7 Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior Comments: <br /> 4 . <br /> i f ^V <br /> v <br /> Q <br /> SUPERVISOR/LEAD SENIOR Approval: i Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITIION(S)? Logg d in LAND USE Book? <br /> age 1 <br /> EH 06 06 Report#7201D O O� \� �� P � April 09,2004 <br />