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SU0010861
EnvironmentalHealth
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SU0010861
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Entry Properties
Last modified
5/7/2020 11:34:48 AM
Creation date
9/9/2019 9:10:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0010861
PE
2631
FACILITY_NAME
PA-1600046
STREET_NUMBER
865
Direction
E
STREET_NAME
ROTH
STREET_TYPE
RD
City
FRENCH CAMP
Zip
95231-
APN
19332016
ENTERED_DATE
4/19/2016 12:00:00 AM
SITE_LOCATION
865 E ROTH RD
RECEIVED_DATE
4/18/2016 12:00:00 AM
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\R\ROTH\865\PA-1600046\SU0010861\APPL.PDF \MIGRATIONS\R\ROTH\865\PA-1600046\SU0010861\CDD OK.PDF \MIGRATIONS\R\ROTH\865\PA-1600046\SU0010861\EHD COND.PDF \MIGRATIONS\R\ROTH\865\PA-1600046\SU0010861\SEPTIC PLAN CHECK.PDF
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EHD - Public
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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010861 <br /> DATE RECEIVED by EHD: April 18,2016 APPL#: PA-1600046 <br /> Referral Agency STAFF CONTACT: MEGAN E AGUIRRE PE : 2631 <br /> - - SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Wed, April 27, 2016 <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;jocation of house,wind direction, etc.... <br /> Public Water: Public Sewer <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> ;/ Ate- • I Q J / <br /> 2,di AA�C�� a � ,' '� 4ui/ �e�"l <br /> -�» p�>-•n.o// � . viS.�-_ G�NA,✓l.t.,cy.,��-- errtJ.v�. <br /> r S cH K l WQ <br /> .Y er too <br /> I recommend: Approval Denial Continuance Inspe El <br /> —� -- <br /> ature <br /> Supervisor/Lead Senior COMMENTS: <br /> (,w *-,J S <br /> b4 <br /> l l : l3ui l� Pda,.,l <br /> • a � <br /> U, o;Cx) ,t 11 � 11 � I <br /> � #jsAne. At& DtlStt`- 1. wsk,-4(.W lruv� 44S�vw / P�Yuti� <br /> S 1Z ax�iI4g �o( GL jPk2 l &011 ( ts' 6 ,U� <br /> s�i7t w ov, '�-t <br /> SUPERVISOR/ LEAD SENIOR Approval: iµ u jDate: <br /> OA II Check Off List: proofread Repo ,._x orrect LAN SE#?Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 April 19,2016 <br />
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