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Complaint Investigation Form Report*51 D4 <br /> COMPLAINT ID: C0004034 ite Location: 500 N JACKTONE RD Account ID. <br /> Receivedby: EED000025 SEDRA Received Date: 9/9/2015 Print Date: 9/9/2015 3:55:37PM <br /> Assigned To: EE0000006 SAEED Assigned Date: 9/9/2015 <br /> Proarem/Element Code 2546-Release/Spill Response(excluding Joint Team) <br /> <br /> <br /> <br /> Nature ofcomplaint: <br /> 45 GALLON MINERAL OIL.ON 09/09/2015TRUCK HIT A POLE AT 11:30 A.M. IN THE PROCESS OF PUTTING UP POLES.CLEAN UP TO BE <br /> COMPLETED ON 09/10/2015. <br /> Complaint Mode: P 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 /> 1-Internet/Email S-Sheriffs Office <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner <br /> Site Location 500 N JACKTONE RPMBA <br /> LINDEN,CA RPAddress <br /> Cross Street <br /> Billing Address <br /> Home Phone <br /> Phone Work Phone <br /> District Location Code <br /> APN t <br /> Date Abated \r `� InspectorlD#: GO I SD.0 <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: �. <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> FIELD ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> Ut-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 Regired-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 <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> omp amt Reviewed by ate. 14 Z L I Updated by. ate: / /Z <br /> 5104 ryl <br />