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SU0010378
EnvironmentalHealth
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SU0010378
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Entry Properties
Last modified
5/7/2020 11:34:32 AM
Creation date
9/4/2019 10:20:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0010378
PE
2631
FACILITY_NAME
PA-1500010
STREET_NUMBER
22769
Direction
N
STREET_NAME
BENDER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00317010 54
ENTERED_DATE
2/2/2015 12:00:00 AM
SITE_LOCATION
22769 N BENDER RD
RECEIVED_DATE
1/30/2015 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\B\BENDER\22769\PA-1500010\SU0010378\APPL.PDF \MIGRATIONS\B\BENDER\22769\PA-1500010\SU0010378\EH COND.PDF \MIGRATIONS\B\BENDER\22769\PA-1500010\SU0010378\EH PERM.PDF
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EHD - Public
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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010378 <br /> DATE RECEIVED by EHD: January 30,2015 APPL#: PA-1500010 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Wed, February 11, 2015 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 22769 N BENDER RD, ACAMPO APN : 00317010 54 <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: _�; 06G (1-J <br /> 1J <br /> ZccaJ <br /> ' /f1� Si7c �n.l��.✓c .�}v�Z�isJi.�.� C�/i�Ls� G,Jl7�l ..5�1�� sYS7r��1� � Lc,�Z[.< it /1.��t�cn.C%' <br /> Ze-)172/ <br /> 12 <br /> _11C=Cs7n�,t�3v�+7��(S 4) fav 43J �zl' un Fe- Y%c sn:s/.y�6 lV1rYJs2blc����c��.��S <br /> t- 7 !:2:- 47 �C� ��2� �i�/•2�z] <br /> I recommend: Approval Denial F] Continuance Inspector: <br /> Signature <br /> Supervisor/Lead SeniorCOMMENTS: <br /> zz,wB Ke <br /> co" -. <br /> lk 02 <br /> Al : ,p 15 <br /> SUPERVISOR/LEAD SENIOR Approval: l Date: <br /> OA Proofread Report? Correct LAND USE#? <br /> Correct CONDITIONS)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 February 02,2015 <br />
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