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NOTE: PULL ALL RMITS (Septic, Well, etc.) MAKEPIES FOR FILE <br /> LAND USE REPORT / — - RECORD ID. SU0007976 <br /> b <br /> DATE RECEIVED by EHD: Novem -r 05,2009 ADPL#: PA-0900266 <br /> Referral Agency STAFF CONTACT: JQ11N,FUNDERBURG PE : 2663 <br /> VARIANCE(VR) <br /> COMPLETE& SUBMIT! '/: Wod, December 2, 2009 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 31011 S TWO I ; ERS RD,�MANTACA APN: 25709011 <br /> In completing the Land Use investigation, dia--all-Pub 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: j 1 vV <br /> The EHD Well Construction Permit will be issued witl�conditions to ensure that the mplaceement <br /> well will be constructed in compliance with current-•California ell Standards, San Joaquin <br /> T� County Well Construction Standards, and Flood Prote�bian Board requirements. The conditions <br /> will include that the well shall be constructed in a manner to prevent surface water from entering - <br /> I reectthe well during flood events, and the well components shall not restrict flows during these times. <br /> Supervisor/Lead Senior <br /> 0q- - <br /> SUPERVISOR/LEAD SENIOR Approval: z Date: 424 l O <br /> Dt Check Off Ussf �� P�lofr�x�� p�rt�' �� � N <br /> I�Ltam ON3�ClN est�8 DJSE Book? x <br /> EH 06 06 Report#7201 November 06,2009 <br />