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_ f <br /> Complaint Investigation Form Report#:5104 <br /> *,�rtpMPLAINT ID: C00021287 Site Location: 2575 COUNTRY CLUB Account ID: <br /> Received by: EE0000418 KITH Received Date: 8/5/2007 Print Date: 8/9/2004 2:57:34PM <br /> Assigned To: EE0000418 KITH Assigned Date: 8/5/2004 <br /> Pro.Qram/Efemenf Code:2547-GENERATOR RESPONSE STANDBY <br /> Complainant: : RICHARD STISSLER-COS Home Phone <br /> Address Work Phone <br /> Nature of complaint., <br /> UNKNOWN GUANTITY OF CONTAMINATED WATER OVERFLOWS INTO STORM DRAINS.MK RESPONDED. <br /> Complaint Mode: A Complaint Mode Codes A-Agency Referral B-Bd of Supervisors i City Council C-Counter <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> PROPERTY INFORMATION ` PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner:KAREN PETRYNA <br /> Site Location 2575 COUNTRY CLUB RP/DSA SHELL OIL PRODUCTS LLC <br /> STOCKTON,CA RP Address 20945 S WILLTNGTON AVE <br /> CARSON,CA 90810 <br /> Billing Address 20945 S WILLTNGTON AVE <br /> Home Phone :559-645-9306 <br /> Phone Work Phone <br /> District Location Code <br /> APN <br /> Date Abated V Inspector., 041 <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Coder <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 14-ENFORCEMENT CASE-Transferred 10 ER FILE <br /> 02-OFFICE ABATED 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 03-NAI SENT 16-LETTER SENT TO TENANT <br /> 04-NOTICE TO ABATE ISSUED 17.15 DAY LETTER SENT <br /> 05-ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL.FILE <br /> 06-EHD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCY 28-FOODBORNE ILLNESS-Unconfirmed <br /> OS-UNABLE TO VERIFY <br /> 29-FOODBORNE ILLNESS-Confirmed <br /> 09-FOODBORNE ILLNESS 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 54-LEAD HAZ DUST EVALUATION SATISFACTORY(5) <br /> DESK <br /> CUPS' <br /> 51C4.rp1 <br />