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POR <br /> LAND USE RET Appy. _ <br /> EHD RECEIVED APP.REFERRAL: _Q f�`�� COMPLETE & SUBMIT BY -- <br /> DATE R <br /> DATE } <br /> ATTN: j e r-1c �- <br /> SITE ADDRESS: 9 led <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: Public sew- <br /> ace-SUMMARY OR COMMENTS:LP <br /> + <br /> e <br /> 0 <br /> r' <br /> I reco end; Approval Denial Continuance Inspector's Signature U��1 <br /> Supervisor/Lead Senior Comments: <br /> res <br /> -O <br /> - - _. ... ..... ..._ ,.... ... -......... .___-_yam!� ------•-- ^.:.__......... r.....�rrcc-r�-r�� ... <br /> bAll liquid and solid dairy wastes and vector complaints from this operation are <br /> to be retained on the premises so as not to cause a nuisance or a health <br /> problem (Porter-Cologne Water Quality Control Act, Chapter 4, Article 4, f <br /> { Section 13260-13263). Any complaints that are verified against this site will ! <br /> be charged the (EHD) hourly rate for response and correction a_ s per Board of L <br /> i <br /> Supervisors Resolution B-92-1591. xoFi>sr:' <br /> -- �_-P___:ad the report? <br /> SUPERVISOR/LEAD SENIOR APPROVAL: j DID YOU USE THE CORRECT: <br /> nd Use#? <br /> Co <br /> ndition(s)#? <br /> JZDid you log it as completed? <br />