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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012482 <br /> DATE RECEIVED by EHD: August 28,2019 APPL#: PA-1900060 <br /> Referral Agency STAFF CONTACT TEDDIE HERNANDEZ PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Fri, August 23, 2019 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 22420 N ST RT 99 WEST FRONTAGE RD,ACAMPO APN : 01319005 <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: Nom Public Sewer: /yo„o <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: 1 / <br /> e /ZIiJ,(ec J TWO faP/¢ //rai <br /> �waGFJJ* "'4e S-riy <br /> L <br /> I recommend: Approval ❑ Denial F-1 Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 heck Off List: Proofread Report? Correct LAND USE#'? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 August 29,2019 <br />