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SU0012236
EnvironmentalHealth
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2600 - Land Use Program
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PA-1600200
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SU0012236
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Entry Properties
Last modified
5/7/2020 11:35:41 AM
Creation date
9/6/2019 10:39:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012236
PE
2631
FACILITY_NAME
PA-1600200
STREET_NUMBER
15467
Direction
E
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240-
APN
05308020
ENTERED_DATE
3/19/2019 12:00:00 AM
SITE_LOCATION
15467 E KETTLEMAN LN
RECEIVED_DATE
4/2/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\K\KETTLEMAN\15467\PA-1600200\SU0012236\APPL.PDF \MIGRATIONS\K\KETTLEMAN\15467\PA-1600200\SU0012236\CDD OK .PDF \MIGRATIONS\K\KETTLEMAN\15467\PA-1600200\SU0012236\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: SU0012236 <br /> DATE RECEIVED by EIID: April 02,2019 APPL#: PA-1600200 <br /> Referral Agency STAFF CONTACT ALISA GOULART PE : 2631 <br /> S{I�j Ew,AnPPRrOV1A9L,-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Thu, April 18, 2019 1 ]t I`� L/�v` l&lbn <br /> Assigned to : EE0009488 Wl3 5< <br /> SITE ADDRESS: 15467 E KETTLEMAN LN, LODI APN : 05308020 <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: NIA Public Sewer: N� <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> 1) Exis�ng Se.�-►;c sys-�e rn SR006Z 2�1�' <br /> 2) s-ti!)s ckomesfiic uoaL, S R Oa 5 1 3-1 1 <br /> I recommend: Approval Q Denial El Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> L9 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> FQA h k ff i • Proofread Report? Correct LAND USE#? <br /> �Corcect CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 April 02.2019 <br />
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