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SU0012580
Environmental Health - Public
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QX-91-0006
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SU0012580
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Last modified
5/18/2020 8:55:12 AM
Creation date
11/18/2019 1:46:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012580
PE
2656
FACILITY_NAME
QX-91-0006
STREET_NUMBER
8500
Direction
N
STREET_NAME
WAVERLY
STREET_TYPE
RD
City
LINDEN
Zip
95236-
APN
09345001, 09345005
ENTERED_DATE
10/2/2019 12:00:00 AM
SITE_LOCATION
8500 N WAVERLY RD
RECEIVED_DATE
9/30/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br />LAND USE REPORT <br />DATE RECEIVED by EHD: September 30, 2019 <br />RECORD ID: SU0012580 <br />APPL #: QX-910006 <br />Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE: 2656 <br />REVISIONS TO ACTIONS (RA) <br />Assigned to : EE0000418 KITH <br />COMPLETE & SUBMIT BY: Thu, October 17, 2019 <br /> <br />SITE ADDRESS: 8500 N WAVERLY RD, LINDEN <br /> <br />APN : 09345001, 09345005 <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: Aiim Public Sewer: 0.410ve <br />Name of Purveyor Name of System <br />SUMMARY OR COMMENTS: Apo,' c.,T3 _ 40_coe. eAt red) it e" LiCe, chriVAT-rea cl de /es" <br /> <br />cee 43oze <br />if 600.4e et eW ot, <br />- 1:),e 4pp I 't• t4rov S doe VIZ -) jet- ,400:11 "l a r", 144 04,1 4=40044 .0,08- .07 / 4j'/* <br />e,,b1-10.01 q- f- 2./7, <br />I recommend: Approval Denial Continuance pi Inspector: <br />Signature <br />Supervisor/Lead Senior COMMENTS: <br />SUPERVISOR / LEAD SENIOR Approval: Date: <br />OA II Check Off List: <br /> <br />Proofread Report? Correct LAND USE #? <br /> <br />Correct CONDITION(S) ? Logged in LAND USE Book? <br /> <br />EH 06 06 Report #720I October 02, 2019
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