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SU0010864
Environmental Health - Public
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SU0010864
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Entry Properties
Last modified
12/8/2020 10:59:41 AM
Creation date
9/4/2019 6:45:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0010864
PE
2690
FACILITY_NAME
PA-1600080
STREET_NUMBER
12552
Direction
N
STREET_NAME
FURRY
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
06114055
ENTERED_DATE
4/19/2016 12:00:00 AM
SITE_LOCATION
12552 N FURRY RD
RECEIVED_DATE
4/18/2016 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\F\FURRY\12552\PA-1600078\CERT OF COMPLIANCE.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: SU0010864 <br /> DATE RECEIVED by EHD: April 18,2016 APPL#: PA-1600080 <br /> Referral Age cy STAFF CONTACT: STEPHANIE STOWERS PE : 2690 <br /> FI LOT LINE ADJUSTMENT(LA) <br /> T BY: Fri, April 22, 2016 <br /> � <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 12552 N FURRY RD,LODI APN : 06114055 <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: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> ' f�!!f'Z�/ �A��cK /f'G�?�►Zt��f��Gd6c c�/L�ilru,A/�tZC#37 htrti. <br /> d44F2 76- !1 Aziz 4 <br /> 3�4# c'1Ayy✓57yZe 1E2�[�f GI�rJJ).Lzet2o��J Ly►.cj <br /> - �' � G?1iGJQ.LiitSZcs f5<Got3 � �cc%t���tts KOZ��. <br /> 'g'1 r6fc`4.0!�?& Lis AO r�r/l)rlc�[5 _1.91/1` s®�Z1f13 i4i GIG�7CccJ <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> Cowes tnN <br /> o� <br /> SUPERVISOR/LEAD SENIOR Approval• — Date: Z� <br /> OA 11 Check Off List: Proofread Report'? c <br /> Correct CONDITION(S)?. Logged in LAND' <br /> EH 06 06 Report#7201 April 19,2016 <br />
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