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SAN JO"UIN COUNTY PUBLIC HEAL-mi SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION LAND USE TRACKING LOG <br /> LAND USE # 5/9 ADDRESS � �0/S �� /Pf• �A?C> �� <br /> SURFACE - SUBSURFACE CONTAMINATION REPORT: SR# <br /> DATE RECEIVED DATE STAFF ACCEPTED REPORT: <br /> PROGRAM ELEMENT APN: <br /> CONDITIONS OF APPROVAL: YES /NO— DATE SATISFIED PERMIT/SR# INITIAL <br /> GENERAL HEADING: - DATE: /a :Zsjf <br /> C. // , 0 5 <br /> D. �/, 0 <br /> E. <br /> F. a. Q 0 <br /> G. <br /> H. <br /> 1. <br /> J. <br /> REVISED CONDITIONS (DATE/COMMENTS): <br /> SOIL SUITABILITY/NITRATE LOADING LETTER: DATE '� - / -7 - O� INIT a"6 <br /> WATER RESULTS WARNING LETTER: DATE INIT <br /> OCCUPANCY SIGN OFF: DATE INIT <br /> SURVEYOR LETTER: DATE INIT <br /> SAMPLING RESULTS: <br /> NITRATE DBCP <br /> EDB ARSENIC <br /> OTHER OTHER <br /> OTHER OTHER <br /> PERCULATION TEST RESULTS: <br /> HOLE # HOLE DEPTH PERC RATE (MIN/IN) PASS/FAIL <br />