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SU0012617
EnvironmentalHealth
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SU0012617
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Entry Properties
Last modified
5/21/2020 9:27:46 AM
Creation date
11/19/2019 1:17:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012617
PE
2690
FACILITY_NAME
PA-1900252
STREET_NUMBER
19950
Direction
N
STREET_NAME
DISCH
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237-
APN
01915022
ENTERED_DATE
10/28/2019 12:00:00 AM
SITE_LOCATION
19950 N DISCH RD
RECEIVED_DATE
10/25/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012617 <br /> DATE RECEIVED by EHD: October 25,2019 APPL#: PA-1900252 <br /> Referral Agency STAFF CONTACT! TEDDIE HERNANDEZ PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: Fri, November 1, 2019 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 19950 N DISCH RD, LOCKEFORD APN : 01915022 <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: N bN"C' Public Sewer: N o t"I s <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> v t-x4, at - C' 5Lb\j tip d a ?,V 0vQU64.,, / 7 # , Uep_ <br /> �-� (t`Q0\Az1 o w A i`—(L, off, l so �k <br /> v� <br /> I recommend: Approva Denial F-1 Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: ` '7 <br /> OA 11 Ch ck Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 October 28,2019 <br />
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