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SU0013225
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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SU0013225
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Last modified
3/10/2021 2:24:26 PM
Creation date
5/7/2020 3:41:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0013225
PE
2632
FACILITY_NAME
PA-2000016
STREET_NUMBER
865
Direction
E
STREET_NAME
ROTH
STREET_TYPE
RD
City
FRENCH CAMP
Zip
95231-
APN
19332026
ENTERED_DATE
5/4/2020 12:00:00 AM
SITE_LOCATION
865 E ROTH RD
RECEIVED_DATE
5/1/2020 12:00:00 AM
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009535 <br /> DATE RECEIVED by EHD: February 20,2013 APPL#: PA-1300007 <br /> Referral Agency STAFF CONTACT: CORINNE KING PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Wed, February 27, 2013 <br /> Assigned to: EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 865 E ROTH RD, FRENCH CAMP APN : 19332016 <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: j Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: -3 ` >`X►��i-"t ro- <br /> 'If ic <br /> CIZ <br /> 1 / ` <br /> Zl'U/ - �. 4cK Sf� ZZ - V 3 — ✓� � • �ic�r�-�! <br /> recommend: Approval �- Denial Continuance F Inspect l <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> Ar ll% �f- <br /> '�� 2 ' 62 <br /> C) 1 <br /> 22.to1 <br /> TNerypAt) �y <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 /> cH 06 06 Report-?'�i February 20,201_ <br />
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