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SU0012667
EnvironmentalHealth
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SU0012667
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Entry Properties
Last modified
1/27/2020 4:48:42 PM
Creation date
12/3/2019 10:42:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012667
PE
2631
FACILITY_NAME
PA-1900194
STREET_NUMBER
105
Direction
W
STREET_NAME
KLO
STREET_TYPE
RD
City
LATHROP
Zip
95330-
APN
19124020, 19124021
ENTERED_DATE
12/3/2019 12:00:00 AM
SITE_LOCATION
105 W KLO RD
RECEIVED_DATE
12/2/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
003
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: SU0012667 <br /> DATE RECEIVED by EHD: December 02,2019 APPL#: PA-1900194 <br /> Referral Agency STAFF CONTACT RICK GRIFFIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Thu, December 26, 2019 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 105 W KLO RD, LATHROP APN : 19124020, 19124021 <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()N f Public Sewer: MAI� <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> 5 r,rf- a r."' ofL <br /> V 0 ,Qy-Apn wit F ; <br /> N"o-Al-I \A L*, A o t �2&-'K"s e s 'r <br /> uo-, QAN� <br /> I recommend: Approval F-1 Denial ❑ Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> A II Check Qff List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 December 03,2019 <br />
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