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NOTE: PULL ALL ,vAMITS (Septic, Well, etc.) MAKE ..,.PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006676 <br /> DATE RECEIVED by EHD: August 02,2007 APPL 9: PA-0700359 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2691 <br /> GP AMENDMENT 10+acres(GP) <br /> COMPLETE& SUBMIT BY: Wed, August 15, 2007 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 10967 N HWY 99 , LODI APN : 05914037 <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 /> • Tri�7�C1tc5rS7c�i�:�-�.sr�����rxa <br /> • �7/ Z,�.aL�L`—Q`-�f�l/��% �/�7��v.�/c �!��G--t>�L'ir7.a�`/L?tL`7!_ �7/t �r2i. y <br /> l9L.ffi.u7/��.=�ti I.�r-�it, �.vDL S�fs91C l� �✓E�J . <br /> - ) o G _ :O/ 6.) 2Z' 90 o C� moi/ <br /> I recommend: Approval Dental Continuance Inspector <br /> Signature- <br /> Supervisor/Lead Senior COMMENTS: <br /> /0 77,-- <br /> /1 ,97 <br /> z7 =� <br /> L� ! /)A5 x/O ji,.! �4s1_ /�/h/1 <br /> SI'PER VISOR/ LEAD SENIOR Approval: Date: <br /> CA h Check Off Lis ,l- Pruofrcad Report? - r <br /> 'Correct(.uNllIIION(S)7 ,u''...ged in '•A`D'bS !69.F�t�77 <br /> ;H 06 06 Repon 47201 August 03,2007 <br />