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NOTE: PULL ALL`„RMITS (Septic, Well, etc.) MAKE SPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004638 <br /> DATE RECEIVED by EHD: September 21,2004 APPL#: PA-04-519 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Tue, October 5, 2004 <br /> Assigned to : EE0000018 TRINDADE <br /> SITE ADDRESS: 8372 S JACK TONE RD, STOCKTON APN : 18308005 <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 /> bel - '- &tA1a� <br /> oA 07 <br /> 1 r)2 0 Z- <br /> I recommend: Approval ® Denial Continuance Inspector:/ <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <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#7201 Pagc 2 September 29,2004 <br />