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Date run : 06/10//96 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report 45104 <br /> Run b MARY`40 Page # S <br /> Copy # 01 o O1 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # : C0006235 Program/Element : e2110 <br /> Taken by : 3973 ROBERT MCCLELLON Date: 06/10/96 Assigned to 3973 ,ROBERT MCCLELLON Date: 06/10/961 <br /> Hard copy Printed: <br /> Facility Name : Fac ID : <br /> BILL to inventoried FACILITY: <br /> Location: JACKTON RD & HWY120 (Must have FACILITY 104) <br /> _ ._........... <br /> Complainant : <br /> : <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: TRI VALLEY BEACONS ............ ------ Code : <br /> Address : JACKTONE _RD/, HWY_ ,_ 805 Dist : <br /> City: APN # <br /> Phone : <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name : BILL_COLWELL_ _._.... __ —_...___Home Phone : <br /> Address : 1253ARRON ..ST . ._....._Wor k Phone : <br /> City : LIVERMORE CA <br /> Nature of Complaint: <br /> 100 GALLON DIESEL SPILL SPILL STARTED ON HWY 99 AND CONTINUED TO <br /> FLYING J <br /> COMPLAINT Info — <br /> COMPLAINT MODE: <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: C>-I_.. <br /> O1-Field 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 07-Refer to Other Agency 08-Not valid 09-Foodborne Illness <br /> Circle appropriate Unit 4 if complaint in another PROGRAM jurisdiction. Have Complaint Record and P/E uodated <br /> Forwarded to UNIT: 1 II II Iv for Investigation <br />