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!�1 o Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00043498 Site Location: JACK TONE RD Account lD: <br /> Receivedby: EE0000009 LOEHRER Received Date: 5/17/2017 Print Date: 5/18/2017 8:44:36AM <br /> Assigned To: EE0000009 LOEHRER Assigned Date: 5/18/2017 <br /> Program/Element Code2548-Non-Release Response-HazCat/Chemical Pickup -- <br /> Complainant: :OFFICER STEEL-CHP Home Phone <br /> Address Work Phone <br /> -Mail Address <br /> Nature of complaint: <br /> A COUPLE GALLONS OF A WHITE GRANULAR POWDER THAT WAS IN THE ROADWAY BUT HAS WORKED IT SELF TO THE SIDE OF THE <br /> ROAD. <br /> Complaint Mode: A Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Cade Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> I-Intemet/Email S-Sheriffs Office _ <br /> -------------------------------------- <br /> PROPERTY INFORMATION <br /> PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner <br /> Site Location JACK TONE RPiDBA <br /> LINDEN,CA RP Address <br /> Cross Street LIVE OAK RD <br /> Billing Address <br /> Home Phone <br /> Phone Work Phone <br /> District : Location Code <br /> APN Row <br /> �l <br /> Date Abated _/l8/w/7 Inspector ID#.' 0XJOC?? <br /> --------------------------------------------------- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: IN <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> n01-Field Response-Violations Cited and Corrected 28-Alleged FBI-No Major Violations Identified <br /> -✓ 29-Alleged FBI-Major Violations Identified <br /> 02-Office Response Only <br /> 50-LEAD Assessment Performed-No Abatement Required <br /> 52-LEAD Abatement Reqired-See Program Record File <br /> 97-Disaster Planning and Response <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-Refferred to Other Agency <br /> 08-Unable to Verify Alleged Complaint MN-EHD Monitoring Status <br /> PD-Permit Issued-Pending Well Installation <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File RS-Resolved-New Well Installed <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> on amt Reviewed by: atmpate y: ate: <br /> 51o4.rpt <br />