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SU0013145
Environmental Health - Public
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SU0013145
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Last modified
7/28/2020 1:57:51 PM
Creation date
5/8/2020 11:46:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0013145
PE
2631
FACILITY_NAME
PA-2000054
STREET_NUMBER
2365
Direction
N
STREET_NAME
WIGWAM
STREET_TYPE
DR
City
STOCKTON
Zip
95205-
APN
13208012
ENTERED_DATE
4/3/2020 12:00:00 AM
SITE_LOCATION
2365 N WIGWAM DR
RECEIVED_DATE
4/3/2020 12:00:00 AM
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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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: SU0013145 <br /> DATE RECEIVED by EHD: April 03,2020 APPL#: PA-2000054 <br /> Referral Agency STAFF CONTACT ALISA GOULART PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Thu, April 30, 2020 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 2365 N WIGWAM DR, STOCKTON APN: 13208012 <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: L olL w4 /7 Public Sewer: 111121yt <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: TA 3`? Ir NI C.. <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signa ure <br /> Supervisor/Lead Senior COMMENTS: <br /> v \J� z wWDA L'(�V"�— �"o �cts�� <br /> l,;v�ta vol L0Csurveto <br /> S �,y�►-r.�E in4f-4 r sP <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> ck Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 April 03,2020 <br />
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