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LUV\ Complaint Investigation Form Report* 5104 <br /> COMPLAINT ID: C00040492 Site Location: 1010 INDUSTRIAL DR Account/D: <br /> Receivedby: EE0003600 BLACKWELL Received Date: 10/8/2015 Print Date: 10/8/2015 11:49:10AM <br /> Assigned To: EE0008709 DELA ROSA Assigned Date: 10/8/2015 <br /> Prooram/Element Code2546-Release/Spill Response(excluding Joint Team) <br /> Complainant: :STATE WARNING CENTER-DARLENE HARDY Home Phone <br /> Address :SIERRA CHEMICALS STOCKTON Work Phone <br /> E-Mail Address <br /> Nature of complaint: <br /> A SERVER THAT IS USED TO TREAT THE CHLORINE BECAME COMPROMISED WHICH RESULTED IN THE SPILL. SPILL IS CONTAINED AND <br /> PENDING INVESTIGATION.CHLORINE CAR WAS TURNED OFF AND VACUUM WAS SET ON ALL PIPES TO CONTAIN THE SPILL.EVACUATION <br /> OF THE SITE(APPROX 28 PEOPLE)HAS BEEN MADE UNTIL CLEARED AND HAZ MAT TEAM IS ON SCENE. <br /> Complaint Mode: A Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> I-Intemet/Email S-Sheriffs Office <br /> --------------------------------------------- -- - <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name:SIERRA CHEMICAL CO(STKN) Responsible Party or Property Owner <br /> Site Location 1010 INDUSTRIAL RP/)BA SIERRA CHEMICAL CO(STKN) <br /> STOCKTON,CA 95206 RP Address 2305 LARKIN CIR <br /> Cmss Street AIRPORT SPARKS,NV 89431 <br /> Billing Address 2305 LARKIN CIR <br /> Home Phone <br /> Phone Work Phone <br /> District 001-VILLAPUDUA,CARLOS Location Code 01-STOCKTON <br /> APN 17728053 <br /> Date Abated Zi1/� Inspector ID#: �A���.�^S+ <br /> f-------------- --- - -- - --- - -- --- --- ----- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Coder <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> �IELD ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 02-OFFICE ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 03-NAI SENT 50-LEAD Assessment Performed-No Abatement Required <br /> 04-NOTICE TO ABATE ISSUED 52-LEAD Abatement Reqired-See Program Record File <br /> 05-DA-ENFORCEMENT ACTION INITIATED 97-Disaster Planning and Response <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-REFERRED TO OTHER AGENCY CL-Case Closed <br /> 08-UNABLE TO VERIFY MN-EHD Monitoring Status <br /> PD-Permit Issued-Pending Well Installation <br /> 10-POSTED SUBSTANDARD/UNSECURED-Sae Housing File RS-Resolved-New Well Installed <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> omp amt Reviewedate:4,= Updatedy: Date: -/ <br /> 5109 ryt <br />