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SU0012964
EnvironmentalHealth
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SU0012964
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Entry Properties
Last modified
6/8/2020 3:19:38 PM
Creation date
1/23/2020 10:18:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012964
PE
2634
FACILITY_NAME
PA-1900293
STREET_NUMBER
19629
Direction
S
STREET_NAME
MOUNTAIN HOUSE
STREET_TYPE
PKWY
City
MOUNTAIN HOUSE
Zip
95391-
APN
25455029
ENTERED_DATE
1/21/2020 12:00:00 AM
SITE_LOCATION
19629 S MOUNTAIN HOUSE PKWY
RECEIVED_DATE
1/21/2020 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
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: SU0012964 <br /> DATE RECEIVED by EHD: January 21,2020 APPL#: PA-1900293 <br /> Referral Agency STAFF CONTACT JOHN FUNDERBURG PE : 2634 <br /> IMPROVEMENT PLAN-MINOR(IP) <br /> COMPLETE&SUBMIT BY: Thu, January 23, 2020 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 19629 S MOUNTAIN HOUSE PKWY, MOUNTAIN APN : 25455029 <br /> HOUSE <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: l�ja r1,pW,, N Vk,,p, t Public Sewer: rw,� spay,"-- <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> Iry <br /> L> t A.N <br /> I recommend: Approval ❑ Denial F-1 Continuance F� Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA II Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 January 21,2020 <br />
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