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SU0012339
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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PA-1600024
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SU0012339
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Last modified
11/19/2024 3:48:17 PM
Creation date
9/9/2019 10:27:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012339
PE
2622
FACILITY_NAME
PA-1600024
STREET_NUMBER
7101
Direction
E
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
APN
04913052
ENTERED_DATE
5/28/2019 12:00:00 AM
SITE_LOCATION
7101 E HWY 12
RECEIVED_DATE
6/10/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\7101\PA-1600024\SU0012339\APPL.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: SU0012339 <br /> DATE RECEIVED by EHD: June 10,2019 APPL#: PA-1600024 <br /> Referral Agency STAFF CONTACP. TEDDIE HERNANDEZ PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Fri, June 28, 2019 <br /> Assigned to : EE0009833 KAUR <br /> SITE ADDRESS: 7101 E HWY 12 , LODI APN : 04913052 <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 diretction, etc.... <br /> Public Water: cyt tvl Public Sewer: y1til" • <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: lq pe I i cd�i oYl �6 r "/ S f)me F-7x- t ns 10 4,n <br /> — Used Condi-tions a ¢ rn✓�L -�-a� y M,�c,G�� c.� FSedth 'S <br /> e ��r dC4rd Mar 2016- <br /> - cc wG,S re(c4ved ih &,tp b v-P <br /> Mwctoc�t l kifig, ( n64 of llS Io- 1�-a <br /> I recommend: Approval Denial ❑ Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <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 June 18.2019 <br />
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