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NOTE: PULL ALL MITS (Septic, Well, etc.) MAKE ,CIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005712 <br /> DATE RECEIVED by EHD: October 18,2005 APPL#: PA-0500702 <br /> Referral Agency STAFF CONTACT: CEALY LEIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Tue, November 1, 2005 <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 8872 W LINNE RD, TRACY APN : 25321005 <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 /> SUPERVISOR/LEAD SENIOR Approval: i Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 October 19,2005 <br />