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SU0011787
EnvironmentalHealth
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SU0011787
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Last modified
5/7/2020 11:35:26 AM
Creation date
9/4/2019 5:20:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0011787
PE
2631
FACILITY_NAME
PA-1800093
STREET_NUMBER
21600
Direction
N
STREET_NAME
DAVIS
STREET_TYPE
RD
City
LODI
Zip
95242-
APN
01308043
ENTERED_DATE
5/2/2018 12:00:00 AM
SITE_LOCATION
21600 N DAVIS RD
RECEIVED_DATE
5/1/2018 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Supplemental fields
FilePath
\MIGRATIONS\D\DAVIS\21600\PA-1800093\SU0011787\APPL.PDF \MIGRATIONS\D\DAVIS\21600\PA-1800093\SU0011787\CDD OK.PDF \MIGRATIONS\D\DAVIS\21600\PA-1800093\SU0011787\EH PERM .PDF \MIGRATIONS\D\DAVIS\21600\PA-1800093\SU0011787\EHD COND.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: S00011787 <br /> DATE RECEIVED by EHD: May 01,2018 APPL#: PA-1800093 <br /> Referral Agency STAFF CONTACT: ALISA GOULART PE : 2631 Plus <br /> SITE APPROVAL-MINOR(S <br /> COMPLETE& SUBMIT BY: Tue, May 22, 2078 <br /> Assigned to : EE0009488 WONG 1 yi <br /> SITE ADDRESS: 21600 N DAVIS RD, LODI APN : 01308043 39 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage disposal, water su <br /> etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population densit/Yoc <br /> of house, wind direction, eNau, <br /> q rn <br /> Public Water: Public Sewer: rU`i/ reel-Mwoc= <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: 914 —odYV✓A/61 n0 <br /> c�dr�ss vn A-FN - � D -35 f <br /> tc% ' <br /> I recommend: Approval ❑ Denial ❑ Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> z <br /> v <br /> r <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 May 02,2018 <br />
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