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SU0004866
EnvironmentalHealth
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SU0004866
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Last modified
5/7/2020 11:31:18 AM
Creation date
9/8/2019 12:37:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004866
PE
2632
FACILITY_NAME
PA-0500086
STREET_NUMBER
6393
Direction
N
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
APN
09746325
ENTERED_DATE
3/2/2005 12:00:00 AM
SITE_LOCATION
6393 N PACIFIC AVE
RECEIVED_DATE
3/1/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\P\PACIFIC\6393\PA-0500086\SU0004866\APPL.PDF \MIGRATIONS\P\PACIFIC\6393\PA-0500086\SU0004866\CDD OK.PDF \MIGRATIONS\P\PACIFIC\6393\PA-0500086\SU0004866\EH 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: SU0004866 <br /> DATE RECEIVED by EHD: March 01,2005 APPL#: PA-05-86 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: TUBS. March ayZ a005 <br /> � Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 6393 N PACIFIC AVE, STOCKTON APN : 09746325 <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 /> I recommend: Approval ❑ Denial ❑ Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> O <br /> /6 :0y <br /> o ; oS <br /> 9�y : ol <br /> SUPERVISOR/LEAD SENIOR Approval: Date: J <br /> OA 11 Check Off List. Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 March 03,2005 <br />
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