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SU0011127
EnvironmentalHealth
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SU0011127
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Entry Properties
Last modified
5/7/2020 11:34:58 AM
Creation date
9/4/2019 10:34:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0011127
PE
2631
FACILITY_NAME
PA-1600261
STREET_NUMBER
12023
Direction
E
STREET_NAME
BRANDT
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237-
APN
05132008
ENTERED_DATE
11/21/2016 12:00:00 AM
SITE_LOCATION
12023 E BRANDT RD
RECEIVED_DATE
11/18/2016 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\B\BRANDT\12023\PA-1600261\SU0011127\APPL.PDF \MIGRATIONS\B\BRANDT\12023\PA-1600261\SU0011127\CDD OK.PDF \MIGRATIONS\B\BRANDT\12023\PA-1600261\SU0011127\EHD COND.PDF \MIGRATIONS\B\BRANDT\12023\PA-1600261\SU0011127\EHD 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: SUo011127 <br /> DATE RECEIVED by EHD: November 18,2016 APPL#: PA-1600261 <br /> Referral Agency STAFF CONTACT: EVAN WATSON PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, December 6, 2016 <br /> q-,)1/ 1121oi Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 12023 E BRANDT RD, LOCKEFORD APN : 05132008 <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: U& 4,-46;�PC�,fttT <br /> c517e !v✓TbIVs Aew, - 4e7,& r'.-oAtz)�) <br /> ' l���E.[GfiLT7/�?/r`rLL3 i� GQ.tlit.F�> 7//c/r�rl�GA.6 ���1�J LL1Ie7�/i2r3ns��nc>2 3+f6') <br /> GUIy// � F�Gis7ee� .Sr�li� Si�S�,� 132r}�l�YL Z3uu<- fi 5f+a u.✓e�t_F�-z� Gt-.E�u�va-e�T. <br /> AI 1/:0� Zz=t,2- eTes7i.� 7,ug-is -ze 452/&Zg� Am0W2 t�fn /?---WXrr-bu <br /> I recommend: Approval Denial ❑ Continuance Inspect o <br /> Signature <br /> Su ervisor/Lead Senior COMMENTS: <br /> /k7 II=a1 <br /> P/) ?2 02 oI - 1 ss UA7vLf-- rs6 T3 P <br /> e) 7Ft� f�4� S9f;,nc_ Ta�r.� Ih 2-0yu�rl,c <br /> JA4y---g !24�±p 17 <br /> � c <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA 11 heck ff <br /> LisV Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Repon 47201 November 21,2016 <br />
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