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NOTE: PULL ALL *..RMITS (Septic, Well, etc.) MAKE --4PIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00004662 <br /> DATE RECEIVED by EHD: October 18,2004 APPL#: PA-04-403 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Tue, November 2, 2004 <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 1075 W TURNER RD, LODI APN : 01505015 <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 /> j -& R A� <br /> I recommend: Approval E-1 Denial ❑ Continuance Inspector: �. <br /> ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> l/ <br /> 8 0 : 0 <br /> 4.1 <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 Paflc 2 October 22,2004 <br />