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SU0009969
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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2600 - Land Use Program
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PA-1400041
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SU0009969
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Entry Properties
Last modified
11/19/2024 3:48:16 PM
Creation date
9/9/2019 10:23:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0009969
PE
2690
FACILITY_NAME
PA-1400041
STREET_NUMBER
11453
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
ENTERED_DATE
3/4/2014 12:00:00 AM
SITE_LOCATION
11453 W HWY 12
RECEIVED_DATE
2/28/2014 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\11453\PA-1400041\SU0009969\APPL.PDF \MIGRATIONS\T\HWY 12\11453\PA-1400041\SU0009969\CDD OK.PDF \MIGRATIONS\T\HWY 12\11453\PA-1400041\SU0009969\EH COND.PDF \MIGRATIONS\T\HWY 12\11453\PA-1400041\SU0009969\EH PERM.PDF
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EHD - Public
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c <br /> NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009969 <br /> DATE RECEIVED by EHD: February 28,2014 APPL#: PA-1400041. <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: e <br /> Assigned to : EE0005944 ESCOTTO <br /> . 3 <br /> SITE ADDRESS: 11453 W HWY 12 ,LODI APN: <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: _'r /9���I: t!ZJ - <br /> Gr>I7&1 A sy'-7--777 1- rQa <br /> o- cia/2 Ato j5LInK s : /'ss /N�rr�a1l'lS�t2�ir �2Ge2 Cs 5�S75 at /: Y" Gl n. <br /> A,b 402!:u elZ-1,&�V /s5t.,,ztS Xc �I roc,crr�v> <br /> Gb " lE C.::2L/6/Z& a fs co//;Yrt 4� -cJ yis .49�IG�Zcct�. <br /> I recommend: ApprovalDenial Continuance Inspectorc- <br /> 11' <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: lm w/ — Date: 3 / / <br /> �A�e k Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 March 04,2014 <br />
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