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NOTE: PULL ALL.v MITS (Septic, Well, etc.) MAKE SPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004481 <br /> DATE RECEIVED by EHD: May 19,2004 APPL#: PA-04-232 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Tue, June 1, 2004 Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 18417 E ST RT 4 HWY, STOCKTON APN : <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 /> - Tse/-j'1�3 ��E7�- .�.s®v�sc� .Jic��v/ s r � is ���.✓� <br /> ,rlD �.s oL S�n��r.�azc�a Gr/Z�s .�• .�.c�-�u,/6�,� �2r,� <br /> c <br /> I recommend: ApprovalDenial Continuance Inspector: ` <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> D � <br /> SUPERVISOR/LEAD SENIOR Approval: ^"`- �- _ 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 97201 Page 5 May 24,2004 <br />