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i <br /> NOTE: PULL ALLMITS (Septic, Well, etc.) MAKE { IES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006726 <br /> DATE RECEIVED by EHD: September 10,2007 APPL#: PA-0700394 <br /> Referral Agency STAFF CONTACT: EVAP G < PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE & SUBMIT BY: k-'a <br /> a Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 12401 N HWY 99 , LODI APN : 05811050 48 49 <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 /> I recommend: Approval Denial Continuance Inspec r• <br /> Signatt e <br /> Supervisor/Lead_Senior„COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> ,Proal'read lYeporE?. <br /> OA511 Cl:ec 'Off <br /> s .+ i Ct 92NI7ITION{S) „ .. ed iAND:L <br /> EH 06 06 Report#7201 September 11,2007 <br />