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S <br /> Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00021894 Site Location: 7939 W 11TH ST AccountlD: AR0002789 <br /> Received by: EE0008373 JACKSON Received Date: 1218/2004 Print Date: 12/9/2004 9:17:27AM <br /> Assigned To: Assigned Date: 12/9/2004 <br /> Propram/Flement Code:4200-LIQUID WASTE PROGRAM! <br /> Complainant: : <br /> <br /> Nature of complaint <br /> WITNESSED WHAT APPEARED TO BE A IMPROPERLY COVERED SEPTIC TANK BEHIND THE BUILDING. <br /> r <br /> f <br /> Complaint Mode: AComplaint Made Codes A-Agency Referral B-Bd of Supervisors!City Council C-Counter <br /> s <br /> E-Code Enforcement M-Mail!Correspondence O-Other EH Unit P-Phone <br /> ---------——————————------------------------------ <br /> FACILITY <br /> ----------------------------- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0003221-JACKS PLACE Owner: OW0002400-MAH,GUEY JACK <br /> Site Location 7939 W 11TH ST RP/DBA JACKS PLACE ! <br /> TRACY,CA 95376 RP Address 31 E GRANT LINE RD J <br /> TRACY,CA 95376 i <br /> Mailing Address. 7939 W ELEVENTH ST Billing Address 31 E GRANT LINE RD <br /> TRACY,CA 95376 TRACY,CA 95376 <br /> Nome Phone � <br /> Phone :209-832-3392 Work Phone :209-832-3399 <br /> District 005-ORNELLAS,LEROY Location Code 99-UNINCORPORATED AREA <br /> APN <br /> Date Abated ,� Inspector., A <br /> Send Referral to. Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: D Complaint History <br /> Attached But Not <br /> Circle appropriate Status Code Scanned <br /> 01-FIELD ABATED 14-ENFORCEMENT CASE-Transferred to 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 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> yi <br /> 08-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed ] <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Confirmed <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> Complaint History <br /> Attached But Not <br /> Scanned <br /> 5104.rpt <br />