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F NOTE: PULL AL ERMITS (Septic, Well, etc.) MAK PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007731 <br /> DATE RECEIVED by EHD: May 15,2009 APPL#: PA-0900118 <br /> Referral Agency STAFF CONTACT: CORINNE KING PE : 2660 <br /> DEVIATION(DV) <br /> COMPLETE &SUBMIT BY: Tue, June 2, 2009 <br /> Assigned to : EE0009649 ESTRADA <br /> SITE ADDRESS: 7493 E HWY 12 , LODI APN : 05135001 <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 /> -S-- � <br /> � <br /> SUPERVISOR/LEAD SENIOR Approval: Date: ('xx <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITIONS)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 May 15,2009 <br />