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COMPLAINT iv: C00047622 <br />Received by: EE0004636 BACKUS <br />Assigned To: EE0004636 BACKUS <br />Complaint Investigation Form <br />Site Location: 1018 SHAW RD <br />Received Date: 10/19/2018 <br />Assigned Date: 10/19/2018 <br />Program/Element Code:2546 - Release/Spill Response (excluding Joint Team) <br />Complainant: : <br /> <br /> <br />Nature of complaint: <br />Report* 5104 <br />Account ID: AR0045557 <br />Print Date: 10/19/2018 4:08:29PM <br />(THERE ARE NO QUALIFIED OR TRAINED PERSONNEL IN THE FACILITY TO SIGNOR MAINTAIN HAZARDOUS WASTE MANIFESTS OR <br />MAINTAIN LABELING OF HAZARDOUS CONTAINERS. COMP -36359 CAL EPA COMPLAINT <br />Complaint Mode: A Complaint Mode Codes A -Agency Referral B-Bd of Supervisors / City Council C -Counter F -Fax <br />E -Code Enforcement M -Mail I Correspondence 0 -Other EH Unit P -Phone <br />I-Intemet / Email S -Sheriffs Office <br />PROPERTY INFORMATION OWNER INFORMATION <br />Facility: FA0024427 - Ampco Pumps Co. - REMANUFACTURING FACILITY <br />Site Location 1018 Shaw Rd <br />Stockton, CA 95215 <br />Cross Street <br />Mailing Address: 1018 Shaw Rd <br />Stockton, CA 95215 <br />Owner: OW0022998 - Mike Nicholson <br />RP/DBA <br />RP Address <br /> <br /> <br /> <br />Home Phone <br />Phone : 414-643-1852 EXT: Work Phone . <br />District 002 - MILLER, KATHERINE Location Code 99 - UNINCORPORATED AREA <br />APN ; <br />Date Abated l Inspector ID #: UW g <br />Send Referral to Referral Letter Sent by <br />Referral Address Date: <br />Complaint Status Code:' <br />Circle appropriate Status Code <br />Field Response -Violations Cited and Corrected <br />50 - LEAD Assessment Performed -No Abatement Required <br />02,office Response Only �'/��^y'/ <br />O6 - iolations Cited -see Linked PROGRAM FACILITY FILE 01) <br />52 - LEAD Abatement Reqired-See Program Record File <br />97 -Disaster Planning and Response <br />Refferred to Other Agency <br />99 - UNSPECIFIED -Old Complaint -No Original Found <br />08 - Unable to Verify Alleged Complaint <br />MN - EHD Monitoring Status <br />10 - POSTED SUBSTANDARD/UNSECURED - See Housing File <br />PD - Permit Issued -Pending Well Installation <br />11 - Multiple Complaints - SEE ACTIVE CASE # <br />RS - Resolved - New Well Installed <br />12 - DA Referred Complaint -See Program Enforcement Action Form <br />S1 -Tank pumped <br />15 - ACTIVE HOUSING CASE - NEW COMPLAINT see ACTIVE CASE # <br />S2 - Hooked up to public sewer <br />28 - Alleged FBI - No Major Violations Identified <br />S3 - Septic system repaired <br />29 - Alleged FBI - Major Violations Identified <br />omp amt Reviewed by: te:2 Updated y: at I <br />DJv� - <br />5104.rpt <br />