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SU0012627 (2)
Environmental Health - Public
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SU0012627 (2)
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Entry Properties
Last modified
4/29/2020 9:47:31 AM
Creation date
11/26/2019 9:14:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0012627
PE
2633
FACILITY_NAME
PA-1900240
STREET_NUMBER
11105
Direction
N
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95242-
APN
05908007, 05908029, 05908030
ENTERED_DATE
11/1/2019 12:00:00 AM
SITE_LOCATION
11105 N HAM LN
RECEIVED_DATE
11/1/2019 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 RECORD ID: SU0012627 <br /> DATE RECEIVED by EHD: November 01,2019 APPL#: PA-1900240 <br /> Referral Agency STAFF CONTACT STEPHANIE STOWERS PE : 2633 <br /> SITE APPROVAL—MAJOR(SA) <br /> COMPLETE&SUBMIT BY: Fri, November 15, 2019 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 11105 N HAM LN, LODI APN: 05908007,05908029,05908030 <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: o NF Public Sewer: N D N k <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: ( U?� -jkcz�'0y S <br /> SNl r�l ii�yl C t c L")ftT S C E.n� <br /> Iwo <br /> W P t wt;do 5 ro o f S-r V-b 'If lr-� <br /> m b P vet vl f o <br /> I recommend: Approval ❑ Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA 11 h ck Off Li Proofread Report? Correct LAND USE#? <br /> ANAWM Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 November 01,2019 <br />
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