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COMPLAINT # : COOO523O Date: 12/28/95 <br /> ]Inspector : Location: JACKTONE RD . 1/2 M N . OF HWY 4 <br /> ----------------------------------------=------------------------ <br /> ------------- <br /> COMMENTS - <br /> #4 : <br /> date / 1 /-& by: 2m <br /> date_/_/_ by:_ �,, n,d ip�-S. - W� ��a 4—E- zy <br /> #5 : <br /> date—/—/_ by: Qa��/L <br /> date_/ /_ by:_ <br /> #6 : <br /> date—/—/— by:— <br /> date—/—/— <br /> y:_date_/_/_ by: <br /> #7 : <br /> date /_/_ by: <br /> date_/ /_ by:_ <br /> #8: <br /> date—/—/— by:_ <br /> date—/—/— by:_ <br /> date—/—/— by:_ <br /> date—/—/— by:_ <br /> date—/—/— by:_ O <br /> Resolved/Abated by: 1 ?;2'�2Name Date_L/4=5L/ <br /> violations: <br /> Enforcement: <br /> CORRESPONDENCE & LEGAL DATES - <br /> NOTICE TO ABATE sent —/—/— _ Office Hearing date / <br /> REFERRAL DATES - (Check Referral Agency and ENTER DATE letter sent) <br /> _ Fire Dept _/_/_ _ Police/Sheriff Dept _/_/_ _ Building/Housing Dept <br /> _ PH Nursing _/_/_ _ Animal Control _/_/_ _ District Attorney <br /> _ State DOW _/_/_ _ Planning Dept <br /> _ Cal-EPA DTSC and/or RWOCB _/_/_ _ Public Works Dept <br /> Third Party Billing Information: <br /> Name: C/O: <br /> Address: <br /> City: State:_ ZIP: <br /> Reviewed by: w Date: <br /> Complaint Record Updated By : �?V5/ Date : / <br /> Revised Report 15104 11/23/94 <br />