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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00039236 Site Location: 1A115 E REDWOOD - 30000 KASSON Account ID <br /> Received by EE0009058 LOWE Received Date: 2/13/2015 Print Date: 2/13/2015 11:52:57AM <br /> Assigned To: EE0004045 TASIOPOULOS Assigned Date: 2/13/2015 <br /> Program/Element Code 4200-LIQUID WASTE PROGRAM <br /> Complainant: Home Phone <br /> Address Work Phone <br /> -Mail Address <br /> Nature of complaint: <br /> SURFACING SEWAGE ( SURE IT IS 1 A 15 E <br /> REDWOOD DR, <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 /> I-Internet/Email S-Sheriffs Office <br /> ------------- -- --- -- -------------------------- --- - <br /> PROPERTY <br /> ----------------------- --- -PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsiblc Party or Property Owner: UNKNOWN <br /> Site Location I A 115 E REDWOOD RP/DBA <br /> TRACY,CA 95376 RP Address <br /> Cross Street <br /> Billing Address <br /> Home Phone <br /> Phone : Work Phone <br /> District 005-ELLIOTT,BOB Location Code 99-UNINCORPORATED AREA <br /> APN <br /> Date Abated Inspector ID#: <br /> — -- — ----- -- — — <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 /> 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 <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 /> 5104 rat <br />