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SU0012359
EnvironmentalHealth
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SU0012359
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Entry Properties
Last modified
5/7/2020 11:35:44 AM
Creation date
9/4/2019 9:35:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012359
PE
2631
FACILITY_NAME
PA-1800318
STREET_NUMBER
12080
Direction
E
STREET_NAME
ACAMPO
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
01727012
ENTERED_DATE
6/5/2019 12:00:00 AM
SITE_LOCATION
12080 E ACAMPO RD
RECEIVED_DATE
6/3/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Supplemental fields
FilePath
\MIGRATIONS\A\ACAMPO\12080\PA-1800318\SU0012359\APPL.PDF
Tags
EHD - Public
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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012359 <br /> DATE RECEIVED by EHD: June 03,2019 APPL#: PA-1800318 <br /> Referral Agency STAFF CONTACT ALISA GOULA_RT PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Thu, June 13, 2019 <br /> Assigned to : EE0009833 KAUR <br /> SITE ADDRESS: 12080 E ACAMPO RD,ACAMPO APN : 01727012 <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: n,�� Public Sewer: (VT(\J/ <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: NO t-itr m I h -N oyid in <br /> I recommend: Approval ❑ Denial F-1 Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA II h k Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 June 05.2019 <br />
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