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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00011318 <br /> DATE RECEIVED by EHD: April 17,2017 APPL#: PA--1700072 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2633 <br /> SITE APPROVAL-MAJOR(SA) <br /> COMPLETE&SUBMIT BY: Wed, April 26, 2017 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 20500 S HOLLY DR, TRACY APN : 21216010 <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, locatio on f ho�lse wmmdd direction, etc.... <br /> Public Water: �/ Public Sewer: <br /> Name of Purve or Name of System <br /> SUMMARY OR COMMENTS: <br /> o -5, y <br /> 21'. yH nlnitj��1� <br /> 210 <br /> hoz: C) <br /> I recommend: Approval ® Denial Continuance Inspe o <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> :u <br /> w <br /> 62 <br /> 020 <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA II h ck ff List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 April 17,2017 <br />