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NOTE: PULL AL�r RMITS (Septic, Well, etc.) MAKE'UdPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005914 <br /> DATE RECEIVED by EHD: February 15,2006 APPL#: PA-0600068 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE & SUBMIT BY: Tue, February 28, 2006 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 15010 N GLASSCOCK RD, LODI APN : 02503004 <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: ncp Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: ���� <br /> civ/S fIYJ/i��r. <br /> f <br /> nY <br /> �tY1v�.r�/ r^fri/ir <br /> Na 22 The existing water pump that is demonstrated south of the project on a separate parcer— <br /> shall be disconnected and drainage ditch water shall not be used for domestic purposes. <br /> This shall be completed under a consultation permit and inspection with the — <br /> Environmental Health Department. The fee for the consultation permit is $93.00. — <br /> I recommend: Approval Denial U Continuance U nspect <br /> Si nature <br /> Supervisor/Lead Senior COMMENTS: <br /> z <br /> 4.� G.v <br /> 5 <br /> On>L, (� <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> EH 06 06 Report 47201 February 15,2006 <br />