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SU0010138
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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2600 - Land Use Program
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PA-1300105
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SU0010138
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Last modified
11/19/2024 3:48:16 PM
Creation date
9/9/2019 10:26:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0010138
PE
2656
FACILITY_NAME
PA-1300105
STREET_NUMBER
5484
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
APN
05516023 25
ENTERED_DATE
7/16/2014 12:00:00 AM
SITE_LOCATION
5484 W HWY 12
RECEIVED_DATE
7/14/2014 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\5484\PA-1300105\SU0010138\APPL.PDF \MIGRATIONS\T\HWY 12\5484\PA-1300105\SU0010138\CDD OK.PDF \MIGRATIONS\T\HWY 12\5484\PA-1300105\SU0010138\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: SU0010138 <br /> DATE RECEIVED by EHD: July 14,2014 APPL#: PA-1300105 RE <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE: 2656 <br /> REVISIONS TO ACTIONS(RA) <br /> COMPLETE &SUBMIT BY: Tue, August 5, 2014 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 5484 W HWY 12 , LODI APN: 05516023 25 <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 /> 4 <, 7-/ S1f�t.L� GY Pzf ,-[3) /4.5 ST47c� /,f,/7� 12 27 <br /> I recommend: Approval [j Denial ❑ Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: k l/j Date: 7 <br /> OA fI Check Off List- Proofread Report? Correct 1,,AND USE#? <br /> Correct C0ND1T10N(S)? 1 o1ged in LAND USE Book? <br /> EH 06 06 Report#7201 <br />
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