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SU0009855
Environmental Health - Public
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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340
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2600 - Land Use Program
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PA-0800350
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SU0009855
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Entry Properties
Last modified
11/19/2024 3:48:16 PM
Creation date
9/9/2019 10:25:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0009855
PE
2625
FACILITY_NAME
PA-0800350
STREET_NUMBER
340
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
APN
05802005
ENTERED_DATE
12/16/2013 12:00:00 AM
SITE_LOCATION
340 W HWY 12
RECEIVED_DATE
12/16/2013 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\340\PA-0800350\SU0009855\APPL.PDF \MIGRATIONS\T\HWY 12\340\PA-0800350\SU0009855\CDD OK.PDF \MIGRATIONS\T\HWY 12\340\PA-0800350\SU0009855\EH COND.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: S00009855 <br /> DATE RECEIVED by EHD: December 16,2013 APPL#: PA-0800350 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2625 <br /> USE PERMIT-MINOR(UP) <br /> COMPLETE&SUBMIT BY: Tue, January 7, 2014 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 340 W HWY 12 , LODI APN : 05802005 <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 /> �tra�Y�'k=xB47ca./s <br /> 1 !JS 444 Cl:;k Z64 6 r-,9 tF+/ s yam.. ef;" c !rt a -1?WA=Z ic/zbc' <br /> TIS-3 ,27 ��1.� tl�cgnrao-�- A 2�i� <br /> I recommend: Approval aDenial ❑ Continuance Inspector: <br /> ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> CS aUG,mttd,.fi.,y� 4 a��wc,�t.f cl-a,61 (� wry, Lfid.ej 6"'4cn <br /> nC 1 r,- d i-+l -rL... dpa.� e4hol /'7 / 2.0 o b' <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List, Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> I_I 106 06 Repon#7201 December 16,2013 <br />
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