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WP0038640
EnvironmentalHealth
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FOREST LAKE
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038640
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Entry Properties
Last modified
4/11/2019 9:31:24 AM
Creation date
4/11/2019 9:29:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038640
PE
4366
STREET_NUMBER
2820
Direction
W
STREET_NAME
FOREST LAKE
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00306031
ENTERED_DATE
8/9/2018 12:00:00 AM
SITE_LOCATION
2820 W FOREST LAKE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
AMeuangkhoth
Supplemental fields
CYEAR
2018
Tags
EHD - Public
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c.:�UNTY I It•--j I I a� <br /> WORKERS CCURRENT ND ACTIVE rWITN TS' STATE LHVVI q1 u IIULr_I E <br /> OMPENSATIO HE CALIFORNIA CONTR hwL' ms's•- • ��. <br /> N LAWS ACTORS STATE LIC( SE BOARD r <br /> SIGNED <br /> _MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR I <br /> _ 6;ECTIONS <br /> ----- _ _ — - TITLE <br /> - �- O <br /> I � o <br /> 1 � <br /> t <br /> ti <br /> q►EPARTMENT USE ONLY <br /> Application Accepted By :,X r) Date <br /> Grout Inspection By �_ Date <br /> Pump Inspection By Date <br /> Soil Boring Inspection By Date <br /> COMMENTS <br /> PE SC Received Check#/ Amount Date Rem -- <br /> itted <br /> Codes Info By Cash Perml� <br /> — Service Re L <br /> t. <br />
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