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Complaint Investigation Form <br /> Report#:5104 <br /> COMPLAINT ID: C00027063 Site Location: 3132 FARMINGTON RD Account/D., AR0005274 I <br /> Received by; EE0005642 HENRY Received Date: 8/28/2007 <br /> Print Date.- q/28/2007 9:13:56AM <br /> Assigned To: EE0007379 BOERTIEN <br /> Assigned Date: 9/28!2007 <br /> Pro ram/Element Code:4300-WELL PROGRAM <br /> Complainant; ;MICHELLE HENRY <br /> Home Phone <br /> Address <br /> Work Phone <br /> Nature of co m laint: <br /> OPEN WELL BEHIND SHOP ON PROPERTY. <br /> -INSPECTOR SHOULD NOT GO ALONE <br /> ---- <br /> Complaint Mode: 0 Complaint ModeCodes A-Agency Referral B-Bd of Supervisors City tY Council <br /> C-Counter <br /> __________—`—— ——'—E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone, I <br /> FACILITY INFORMATION —� -- --------------- i <br /> OWNER INFORMATION 1 <br /> i <br /> Facility:FA0004837-MR B'S ENTERPRISES INC Owner: OW0003740-RICHARD O BYWATER b <br /> Site Location 3132 FARMIINGTON RD RP/DBA MR B'S ENTERPRISES INC I <br /> STOCKTON,CA 95205 RP Address PO BOX 31600 <br /> STOCKTON,CA 95213 <br /> Mailing Address: PO BOX 31600 Billing Address PO BOX 31600. <br /> k <br /> STOCKTON,CA 95213-1600 STOCKTON,CA 95213-1600 <br /> Home Phone ; F <br /> Phone :209-942-3131 Work Phone <br /> District 001 -GUTIERREZ,STEVE r'Location Code 01 -STOCKT, N <br /> APN 17306002 <br /> Date Abated i <br /> Inspector: , <br /> -- ----- __ __ <br /> Send Referral to —T `w Refers!Letter Sent by —— — <br /> Referral Address <br /> Date: <br /> Ih <br /> Complaint Status Coder <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 14.-ENFORCEMENT CASE-Transferred to ER FILE <br /> 02-OFFICE ABATED <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE'# <br /> 03-NAI SENT 16-LETTER SENT TO TENANT <br /> I 04-NOTICE TO ABATE ISSUED 17-15 DAY LETTER SENT ' <br /> 05-ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE i <br /> 06-EMD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE r <br /> O}REFERRED TO OTHER AGENCY 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> OB-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed!No Major Violations I <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 30-15 Day Letter Sent-Confirmed Complaint <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 31-15 Day Letter Sent-Alleged Complaint Complaint H iF(0r> <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 50-LEAD HAZ EVALUATION REQUIRED(1) Attache&But Net <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) SCa" ed <br /> I� <br /> I I <br /> 5104.r <br /> t <br /> P I <br /> i <br /> I� <br />