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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00038740 Site Location. 3672 COUNTRY CLUB BLVD Account ID. <br /> Received by EE0000001 TURKATTE Received Date: 10/22/2014 Print Date: 10/22/2014 2:14:15PM <br /> Assigned To: EE0002424 VELOSO Assigned Date: 10/22/2014 <br /> Program/Element Code 1322-SUBSTANDARD HOUSING h�,/�� <br /> Complainant: BOS-LARRY RUHSTALLER C✓,vk OCG iG '4-t T+CSC� t L1'fdllfee)hone <br /> Address Work Phone <br /> -Mail Address <br /> Nature of com laint: <br /> HOUSE IS FALLING DOWN. <br /> Complaint Mode. P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors!City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail!Correspondence O-Other EH Unit P-Phone <br /> ]-Internet/Email S-Sheriffs Office <br /> ------------- <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner:LISA WONG <br /> Site Location 3672 COUNTRY CLUB RP/DBA <br /> STOCKTON,CA RP Address 3672 COUNTRY CLUB BLVD <br /> Cross Street STOCKTON,CA 95204 <br /> Billing Address 3672 COUNTRY CLUB BLVD <br /> Home Phone <br /> Phone Work Phone <br /> District 002-RUHSTALLER,LARRY Location Code 99-UNINCORPORATED AREA <br /> APN 12103025 <br /> Date Abated QI Z.-3//Ll Inspector ID#: <br /> --- -- — <br /> — ———————— — - -- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: CA <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 01-FIELD ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 02-OFFICE ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 03-NAI SENT 50-LEAD Assessment Performed-No Abatement Required <br /> 04-NOTICE TO ABATE ISSUED 52-LEAD Abatement Reqired-See Program Record File <br /> 05-DA-ENFORCEMENT ACTION INITIATED 97-Disaster Planning and Response <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 60 REFERRED TO OTHER AGENCY CL-Case Closed <br /> 08 UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11 -Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 5104 rpt <br />