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CO0001254
EnvironmentalHealth
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2500 – Emergency Response Program
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CO0001254
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Entry Properties
Last modified
12/6/2024 10:42:36 AM
Creation date
2/8/2019 9:16:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0001254
PE
2531 - GEN <5 TON COMPS
STREET_NUMBER
575
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
ENTERED_DATE
1/4/1994 12:00:00 AM
CURRENT_STATUS
Closed
SITE_LOCATION
E/S 575 W GRANT LINE RD
RECEIVED_DATE
1/4/1994 12:00:00 AM
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\lsauers1
Supplemental fields
FilePath
\MIGRATIONS\G\GRANT LINE\575\CO0001254.PDF
Site Address
575 W GRANT LINE RD TRACY 95376
Tags
EHD - Public
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State B/California—Environmental Protection Agency Department of Toxic Substances Control <br /> COMPLAINT REPORT FORM <br /> (Use ball-point pen) Log Number., I ' <br /> INFORMANT ALLEGED RESPONSIBLE PARTY <br /> Name: /' "' Name: <br /> <br /> <br /> <br /> <br /> ` - ' -�- City: ZIP: <br /> LA Confidential OR ❑ Anonymous: (Check one) County Code: Phone: ( ) <br /> COMPLAINT DATA <br /> Is this an emergency? ❑ Yes Q No If yes, call the Office of Emergency Services (OES): 800-852-7550 <br /> Log Number: - - Date Complaint Received: ' / - Time: /J cr .+ Received By: ::7,- <br /> Notifications made (Yes/I(o),Orop. 65 Local Agency Who? <br /> Date of Incident: - -r• Allegation Code: �/ Quantity: - �• <br /> Type/Condition of Containers Visible: <br /> Source of Complaint/Code: If Code A, Specify: <br /> Other Comments: <br /> COMPLAINT COORDINATORS ONLY <br /> Response Code - Region/Agency Referred To: <br /> Response Date: Investigator: Date Assigned: <br /> Note: Information to be transferred to complaint log is highlighted in bold italic print. Attach an addendum if necessary. <br /> See code on reverse side. <br /> White Regional Office Yellow—Log Pink—Investigations Green—Informant <br /> DTSC 1017 (10/61) <br /> (Formerly DHS 6231 end DHS 8073) vi 93M <br />
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