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NOTE: PULL ALL ,..RMITS (Septic, Well, etc.) MAKE %—.oPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004664 <br /> DATE RECEIVED by EHD: October 18,2004 APPL#: PA-04-530 <br /> Referral Agency STAFF CONTACT: RAYMOND HOO PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE& SUBMIT BY: Tue, November 2, 2004 <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 19850 N THORNTON RD, LODI APN : 10315007& 15 <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 ❑ Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> iv <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA II Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Pagc 4 October 22,2004 <br />