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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00038429 Site Location: 10878 HWY 99 Account ID AR0001144 <br /> Recerved by. EE0002670 NAIDU Received Date: 8f27/2014 Print Bate: 8/27/2014 8:14:27AM <br /> Assigned To: EE0000005 ZAREEF Assigned Date: 8/27/2014 <br /> PrQgram/Flemer0 Code 7546-Release/Spill Response(excluding Joint Team) <br /> Compla+Want. JASON HARPER Nome Phone <br /> Address Work Phone <br /> -Mai!Address <br /> Nature of corn taint: <br /> A LADY PULLED UP TO THE GAS STATION WITH A LEAKING TANK(4-5 GALLONS OF GASOLINE).WATERLOO/MORADA FIRE RESPONDED <br /> CLEANED UP USING ABSORBENT AND EITHER LEFT IT IN A PILE OR THREW IT IN THE GARBAGE. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors t City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> I-Internet/Email S-Sheriffs Office <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0001146-Mill( [I lr AVl Jrii FAST ISI EASY#60* Owner: OW0000885-Al-1,ASI IRAF <br /> Site Location RP/DBA MORADA CHEVRON FAST N EASY#60 <br /> STOCKTON.CA 95212 RP Address 20 TWELVE OAKS DR <br /> Cross Street FR PLEASANTON,CA 94566 <br /> Mailing Address: 5000 E 2ND ST STE G billing Address 5000 E 2ND ST STE G <br /> BENICIA,CA 94510-101 BENICIA,CA 94510-101 <br /> Home Phone :925-998-7299 <br /> Phone :209-931-6154 EXT: Work Phone :707-747-2955 EXT: <br /> District 004-VOGEL,KEN Location Code <br /> APN 08607002 <br /> Date Abated 114 Inspector ID <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 /> '(➢3/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 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 SUBSTANDARDIUNSECURED-See Housing File <br /> 11 -Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 5104 rpt <br />