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NOTE: PULL ALL P.-AMITS (Septic, Well, etc.) MAKE C%vPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004657 <br /> DATE RECEIVED by EHD: October 07,2004 APPL#:—.QX-94-02(RA) ''p <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2656 <br /> REVISIONS TO ACTIONS-STAFF <br /> COMPLETE& SUBMIT BY: Wed, October 27, 2004 REVIEW APDL(SR) <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 24717 E BRANDT RD, LODI APN : 02316002,03& <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 <br /> M <br /> !Ik <br /> i E <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> SupervisorfLead Senior COMMENTS: <br /> WV <br /> I� <br /> F <br /> F <br /> b <br /> l <br /> if <br /> SUPERVISOR 1 LEAD SENIOR Approval: Date: a <br /> OA!!Check Off List: P& frcad Report? Correct LAND.aIF#7 <br /> CorrectC©NDITON(S)? ..:. Logged`[n i;AND USE_Book? <br /> October OS,2004 <br /> EH 06 06 Report#7201 Page 5 <br />