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SU0010967
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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JACK TONE
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2600 - Land Use Program
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PA-1600155
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SU0010967
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Entry Properties
Last modified
5/7/2020 11:34:52 AM
Creation date
9/6/2019 10:25:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0010967
PE
2622
FACILITY_NAME
PA-1600155
STREET_NUMBER
23800
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
02105019
ENTERED_DATE
7/8/2016 12:00:00 AM
SITE_LOCATION
23800 N JACK TONE RD
RECEIVED_DATE
7/1/2016 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\J\JACK TONE\23800\PA-1600155\SU0010967\APPL.PDF \MIGRATIONS\J\JACK TONE\23800\PA-1600155\SU0010967\CDD OK.PDF \MIGRATIONS\J\JACK TONE\23800\PA-1600155\SU0010967\EHD COND.PDF \MIGRATIONS\J\JACK TONE\23800\PA-1600155\SU0010967\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: SU0010967 <br /> DATE RECEIVED by EHD: July 01,2016 APPL#: PA-1600155 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, July 19, 2016 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 23800 N JACK TONE RD, ACAMPO APN: 02105019 <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: <br /> SGC(/ rZ <br /> f�.3 �/ c'Q/5i�7� s-�✓1�2�i �r � /irn�I •� ra✓`1�6�5�✓/� z�t�c__ /�>rz//�✓ <br /> -z-/u se4,fir/6lBs7 QliL C-4Q <br /> 7� .�-�/�-old 11�.�[l�'n- �/T-�,.� A .r><t�u//.�1���.=c�n�✓c� �+� <br /> �1 60:>� z9, 7d*7 4e' Le '64yYrE-� LyZY,rr --5e -717 2tAa�� Lr.C7.0 <br /> — ,CGsrYYY 94Z �f1 !/:!/a t', yzel �� /� RP7-.A471i0 ^L A: i Zl-.,C(,7 <br /> I recommend: Approval Denial Continuance ❑ Inspec <br /> Signature <br /> Sunervisor/Lead Senior COMMENTS: <br /> 4P VV W-410� <br /> t1,x�•t•. 'Loo'. 0�. ' 0�;5w.,iWl (^.+v..a-a.'7l' 1Y <br /> (.� Z2��1 — y.Jwr�� - Q<,c� � C,-w�Gati � tu..t�..U•-(/� <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA II Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> v.nh P.�pnri=" i Jul,W 2016 <br />
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