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SU0013199
Environmental Health - Public
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2600 - Land Use Program
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PA-2000023
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SU0013199
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Last modified
11/19/2024 3:48:19 PM
Creation date
5/7/2020 3:39:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0013199
PE
2620
FACILITY_NAME
PA-2000023
STREET_NUMBER
10400
Direction
E
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
APN
05112088
ENTERED_DATE
4/27/2020 12:00:00 AM
SITE_LOCATION
10400 E HWY 12
RECEIVED_DATE
4/17/2020 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: SU0013199 <br /> DATE RECEIVED by EHD: April 17,2020 APPL#: PA-2000023 <br /> Referral Agency STAFF CONTACP. STEPHANIE STOWERS PE : 2620 <br /> DEVELOPMENT AGREEMENT(DA) <br /> COMPLETE& SUBMIT BY: Thu, May 14, 2020 <br /> Assigned to: EE0000418 KITH <br /> SITE ADDRESS: 10400 E HWY 12 , LODI APN : 05112088 <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 /> I recommend: Approval ❑ Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> [_QA1l Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 April 28,2020 <br />
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