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CO0007987
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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CO0007987
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Entry Properties
Last modified
10/9/2019 8:55:51 AM
Creation date
1/30/2019 4:50:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
RECORD_ID
CO0007987
PE
2300
FACILITY_ID
FA0019940
FACILITY_NAME
DANSON VAN & STORAGE
STREET_NUMBER
1610
Direction
N
STREET_NAME
BROADWAY
STREET_TYPE
AVE
City
STOCKTON
ENTERED_DATE
4/4/1997 12:00:00 AM
SITE_LOCATION
1610 N BROADWAY AVE
RECEIVED_DATE
4/3/1997 12:00:00 AM
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\B\BROADWAY\1610\CO0007987.PDF
Tags
EHD - Public
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Hate run: 04/04/97 SAN JOAQUIN COUNTY PUBLIC. HEALTH SERVIC Report 15104 <br /> Run by : MARY O Page # 1 <br /> Copy # : 01 of COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # = 00007987 Program/Element : 2300 <br /> Taken by : 0418 MICHAEL KITH Date: 04/04/97 Assigned to :.0008 LETITIA BRIGGS Date: 04/04/97 <br /> Hard copy Mated, <br /> Facility Name: _ Fac ID: <br /> BILL to inventoried FACILITY: <br /> Location: 16.1.0 N_._BROA©WAY-AVS (Must have FACILITY IDI) <br /> Complainant: 34HN CASEYHome Phone: 2 <br /> Address: 1b1Q X BROADWAY AVE -.---,--.-._...._...______.___........._Work Phone: 0 Oq, *4,'f-73 V-3 <br /> STOCKTON CA c7Jr. ,440 <br /> FACILITY LOCATION/Property Info - <br /> DBA or Name: DANSON VAN & _5T©RAGE._..._._..._..----....�. .-- ---.__-.-.-Loc Code <br /> Address. 1610-N_Bf OQok# Y_._AVE_ ......._...._......_._.----._-._-. ---.....__._..-.____._.___._......_BOS Dist <br /> City: STOCKTON APN # : <br /> Phone'. <br /> BILLING ,%WNSIBLE PARTY or7RTInfoNa SMITH h J 7Hgme Phone: <br /> Address: �otr �,..._.__ ..w..-_. Wor k Phone: <br /> city: _ --- Aim)AS 40 D 7r7 <br /> latuTe of Colplaint: <br /> THERE, MAY BE Af UST ON SITE . THERE ARE VENT PIPES , CONCRETE AND FILL <br /> BOX <br /> COMPLAINT Info - <br /> COMPLAINT NODE: <br /> A-*Isecy Referral . B-BD OF Supsrvisors/City Ccouncil C-Counter H-Mail/Correspondence <br /> 0-other EH Unit P-Phone <br /> COLAINT`STAT JS: Q p <br /> 014414 Wtod ' 02-Office Abated 03-IW-Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06 Transfer to Premise File 07-Refer to Other Agency 08-Non valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by: Date: <br /> Circle appropriate Unit 1 if complaint is `another PRMN jurisdiction, Have Complaiot,Record and PIE updated <br /> Forwarded to UNIT: 1 II III Iv for Investigation <br />
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