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NOTE: PULL ALL P RMITS (Septic, Well, etc.) MAKE 6IE8 FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004576 <br /> DATE RECEIVED by EHD: July 20,2004 APPL#: PA-04-250 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2605 <br /> EXCAVATION-QUAIMV(QX) <br /> COMPLETE&SUBMIT BY: Wed, August 11, 2004 <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 22469 S HENRY RD, ESCALON APN : 24905017 <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 /> L/6/ y— F o <br /> I recommend: Approval ❑ Denial ❑ Continuance Inspector: <br /> Supervisor/Len The San Joaquin County Development Title Requirements listed below have been identified as <br /> pertinent to this project. Other requirements may also apply. These requirements cannot be <br /> modified. <br /> A. No excavations are permitted into the ground water table without specific approval from the <br /> Regional Water Quality Control Board, Central Valley Region (California Water Code, _ <br /> Chapter 4, Article 3, Section 13240). <br /> B. The materials from an excavation shall not be deposited into any watercourse or in any way <br /> contribute to the pollution thereof(California Water Code, Section 13376). — <br /> C. An approved potable water supply must be provided for all employees (San Joaquin County <br /> Development Title, Section 9-1100.1). <br /> D. Approved sanitary facilities must be provided for all employees(San Joaquin County <br /> Development Title, Section 9-1100.1). <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged io LAND USE Book? <br /> i1 6 :aaor-_.i1 Page l July 27,2004 <br />