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Complaint Investigation Form <br />COMPLAINT ID: C00021287 Site Location: 2575 COUNTRY CLUB Account ID: <br />Received by: EE0000418 KITH Received Date: 8/5/2004 <br />Assigned To: EE0000418 KITH Assigned Date: 8/5/2004 <br />Location Code <br />Program/Element Code: 2547 - Release Response STANDBY (Not in Use 8-2014) <br />Nature of complaint: <br />JNKNOWN GUANTITY OF CONTAMINATED WATER OVERFLOWS INTO STORM DRAINS. MK RESPONDED. <br />3-9-04 MK - SEE ER REPORT AND FILE. <br />Complaint Mode A Complaint Mode Codes A -Agency Referral B-Bd of Supervisors/City Ci C -Counter E -Code Enforcement <br />M-Mail/Correspondent O -Other EH Unit P -Phone <br />FACILITY INFORMATION <br />OWNER INFORMATION <br />Facility: FA0006439 - California Fuel Supply <br />OW0013503 - California Fuel Supply <br />RP DBA:COUNTRY CLUB VALERO <br />Site Location: 2575 COUNTRY CLUB BLVD <br />RPAddress587 YGNACIO VALLEY RD <br />Stockton, CA 95204 <br />WALNUT CREEK, CA 94596 <br />Mailing Address 587 Ygnacio Valley Road <br />Billing Address587 Ygnacio Valley Road <br />Walnut Creek, CA 94596 <br />Walnut Creek, <br />Phone 1st: 209-932-1307 EXT: <br />Phone Hm: 415-516-7676 <br />Wk: Number Not Specified <br />District <br />Location: <br />APN <br />Report #: 5106 <br />************************ ABATEMENT SUMMARY *********************** <br />Status Employee ID and Name Abatement Date <br />08 EE0000418 - KITH, MICHAEL 8/9/2004 <br />Abatement Status Codes <br />O1 -Field Abated <br />02 -Office Abated <br />03 -NAI Sent <br />04 -Notice to Abate Issued <br />06-EHD Permit Facility -See Linked Facility File <br />07 -Referred to Other Agency <br />5106.rpt <br />08 -Unable to Verify 15 -Active Housing Chsa-New Gmplaint-See Ac iw Case # <br />I0 -POSTED Sibstandar&U-secu ivd-See 1 busing File 28-FOODBOLPM ILLNESS —No Major Violations Idartified <br />11-Nidtiple Complaints -See Active Case # 29-FOODBO LME ICINESS—Major Violations Identified <br />12 -DA Referred Con -plaint -See Violation Tracking FornfiO-LEADAssessn ert Ierforrred—No Abater rent Required <br />52 -LEAD Abatement Required—See Program Record File <br />99 -Unspecified— Old Corrplairt —Ot iginal not Available <br />