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SU0013447
EnvironmentalHealth
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SU0013447
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Entry Properties
Last modified
6/25/2020 9:41:09 AM
Creation date
6/11/2020 3:36:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0013447
PE
2631
FACILITY_NAME
PA-2000065
STREET_NUMBER
17400
Direction
W
STREET_NAME
BETHANY
STREET_TYPE
RD
City
TRACY
Zip
95391-
APN
20915029
ENTERED_DATE
6/11/2020 12:00:00 AM
SITE_LOCATION
17400 W BETHANY RD
RECEIVED_DATE
6/9/2020 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: SU0013447 <br /> DATE RECEIVED by EHD: June 09,2020 APPL#: PA-2000065 <br /> Referral Agency STAFF CONTACT' FRANK GIRARDI PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Mon, June 22, 2020 <br /> Assigned to: EE0000418 KITH <br /> SITE ADDRESS: 17400 W BETHANY RD,TRACY APN : 20915029 <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: r✓o.,e- Public Sewer: may,-C <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> 4/{ �r �,� ��.,,7� lGi4—"C- -4-0LSI-CM-4 <br /> �r ti <br /> I recommend: Approval ❑ Denial ❑ Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 1l Check Off List: Proofread Report? V Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 June 11,2020 <br />
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