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SU0009688
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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5136
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2600 - Land Use Program
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PA-1300091
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SU0009688
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Last modified
11/19/2024 3:48:15 PM
Creation date
9/9/2019 10:25:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0009688
PE
2625
FACILITY_NAME
PA-1300091
STREET_NUMBER
5136
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95242-
APN
05516024, 43, 44 & 73
ENTERED_DATE
7/9/2013 12:00:00 AM
SITE_LOCATION
5136 W HWY 12
RECEIVED_DATE
7/8/2013 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\5136\PA-1300091\SU0009688\APPL.PDF \MIGRATIONS\T\HWY 12\5136\PA-1300091\SU0009688\EH COND.PDF \MIGRATIONS\T\HWY 12\5136\PA-1300091\SU0009688\EH PERM.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: SU0009688 <br /> DATE RECEIVED by EHD: July O8,2013 APPL#: PA-1300091 <br /> Referral Agency STAFF CONTACT: JOHN L FUNDERBURG PE : 2625 <br /> USE PERMIT-MINOR(UP) <br /> COMPLETE&SUBMIT BY: Wed, July 31, 2013 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 5136 W HWY 12 , LODI APN : 05516024,43,44&73 <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: /Qi/ ��: —rice rs) Z,-, 6 5'11 ((E 14,42 /tffSZF_� l9lZS <br /> T- (c g e2j124/A S -<70"' / ,-Zc- ZJW/4710Y7 <br /> he3�LCT Z/C'&t- 4e /S el-74 ,R5 Akl o- <br /> 2-2- <br /> L <br /> I recommend: ApprovalDenial Continuance Inspect <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> b(F® 1� 05: 267a� <br /> (R� z7-0-� tW- 60 <br /> SUPERVISOR/LEAD SENIOR Approval: P(A- t/^f.)' Date: / <br /> EH 06 06 Report#7201 <br /> July 09,201'_ <br />
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