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Complaint Investigation Form <br /> COMPLAINT ID: C00045173 Report#:5104 <br /> Site Location: 16750 N CLEMENTS RD <br /> Received b : Account IDY EE0003600 BLACKWELL <br /> Assigned To: EE0006219 DUNCAN Received Date: 11/27/2017 <br /> Prin <br /> Assigned Date: 11/27/2017t Date: ((/27/2017 1:52:40PM <br /> Pro remrFl nt a 1322-SUBSTANDARD HOUSING <br /> Complainant: :ANONYMOUS <br /> Address ; Home Phone <br /> Work Phone <br /> Nature of com taint: -Ma#Address <br /> COMPLAINANT STATES CHANGING ELECTRICAL WITHOUT PERMITS AND POWER REGULATION-PUT IT ON-SITE. <br /> Complaint Mode: p Complaint Motle Codes <br /> A-Agency Referral B-8d of Supervisors/City Council <br /> E-Code Enforcement M- C-Counter F-Fax <br /> Mail/Correspondence O-Other EH Unit <br /> ______ I-Internet/Email P-Phone <br /> PROPERTY INFORMATION ——————ssh—es o rce <br /> Property Name: PROPERTY OWNER INFORMATION <br /> Responsible Party or Property Owner:CHEN,XIAO XUN ETAL <br /> Site Location 16750 N CLEMENTS <br /> LODI,CA 95240 RP/DBA <br /> Cross Street BRANDT RP Address <br /> <br /> <br /> Phone Home Phone <br /> Work Phone <br /> Distdot 004-WINN,CHARLES <br /> APN 05320015 Location Code 99-UNINCORPORATED AREA <br /> Date Abated <br /> __ Inspector ID#: <br /> Send Referral to ———— <br /> Referral Address Referral Letter Sent by <br /> Date: <br /> Complaint Status Coder <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Corrected <br /> 50-LEAD <br /> 02-Office Response Only Assessment Perrormed-No Abatement Required <br /> 06-Violations Cited-see Linked�1PROGRAM FACILITY FILE 52-LEAD Abatement Regired-See Program Record File <br /> `,:Y Reffened to Other Agency /�6N aH vs•- ,I _ 97-Disaster Planning and Response <br /> '1r T 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08-Unable to Verify Alleged Complaint �-`�I" <br /> 10-POSTED SUBSTANDARD/UNSECURED- MN-EHD Monitoring Status <br /> See Housing File PD-Permit Issued-Pending Well Installation <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-OA Referred Complaint-See Program Enforcement Action Form RS-Resolved-New Well Installed <br /> S <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# 2-Tank pumped <br /> S2-Hooked system <br /> to public sewer <br /> 28-Alleged FBI-No Major violations Identified <br /> 29-Alle ed FBI- S3-Septic system repaired <br /> 9 Major Violations Identified <br /> ompaint eviewe y: <br /> 'y1 Date:/� Updated by: <br /> 5104.rpt _/ / <br />