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/qc <br /> NOTE: PULL ALL PERNt.s'S (SEPTIC, WELL, ETC...) l\_,_,,,KE COPIES FOR FILE <br /> ,AND USE REPORT APP# S/} --QQ-/6 <br /> EHD RECEIVED APP.REFERRAL: "1'� `T-� COMPLETE & SUBMIT BY ,.J5--A� U <br /> DATE DATE <br /> ATTN• `1��n6 11 r-rnc 4 <br /> SITE ADDRESS: d <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposal, <br /> water supplies, etc...). Where necessary, on an attached piece of plain paper, draw completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Pd Public sewage: NJ <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval &-`- Denial Continuance Inspector's Signk r�_7 G <br /> Supervisor/Lead Senior Comments: <br /> un <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECKOFF LIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />