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NW'E: PULL ALI ,.eERMITS (Septic, Well, etc.) MAKE'', IES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008676 <br /> DATE RECEIVED by EHD: March 17,2011 APPL##: PA-1100043 <br /> Referral Agency STAFF CONTACT: CORINNE KING PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE &SUBMIT BY: Wed, March 30, 2011 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 24511 N HWY 99 ,ACAMPO APN : 0051601519 <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 /> Narne of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> L13l��Ll <br /> •. �i�.��(�-L- Z�Sr3�zrG 5'�I�� Ga'-f7e�aK7 <br /> / O' <br /> !`.R-f`iJ ,�L(�C #r L��'t/ 7"� <br /> I recommend: Approval Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> "A permit to temporarily close the underground storage tank system must be obtained from this department prior -- <br /> _.to disconnecting the monitoring system. Permits must be obtained from this department to retrofit, install, and ' <br /> operate underground storage tanks. Contact Aris Cacapit, Senior REHS, at (209) 468-3453 with questions in the <br /> permitting.process. Also contact the San Joaquin County Office of Emergency Services-at(209) 953-6200 for any <br /> possible changes to your business plan." <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> :OR it trhek Off Ltst a� ; opratl�egart; ' C9 <br /> clre�tEL�113 C7$F� <br /> .a�r # <br /> s: ¢ arrectdNDTTI;9N <br /> a <br /> EH 06 06 Report 47201 <br /> March 17,2011 <br /> i <br />