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a i� run. _ Report <br /> Rt.i.n by : CAROLD/ � Page # 8 <br /> Copy # : 01 of 0QCOMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # : C0008675 Program/Element : 2531 <br /> %ksn by : 060$ TREVF.N+ Date: 07/25/07 Assigned to ; 060E TRBVENA Date: 0?/25/4T <br /> Hard copy Printed; <br /> Facility Name : _ Fac ID: <br /> BILL to inventoried FACILITY: <br /> Location: 25533 N. HWY 99 W. FRONTAGE RD fN,ist have FACILITY 1110 <br /> Complainant : O.E. S . Home Phone : 2.09-468-3969 <br /> Address : Work Phone: <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: _ _ Loc Code : <br /> Address : _BOS Dist : <br /> City: -- -- .APN # <br /> Phone : <br /> BILLING RESPONSIBLE PARTY or OWNER info — <br /> Name : Home Phone : <br /> Address : --- - — -- — Work Phone: <br /> City: — --- -- --------- -------- <br /> Natare of Complaint: <br /> TWO DRIIMS APPEAR TO HAVE SOME TYPE OF CONTAMINTTON . DIRT AND DEBRIS . <br /> COMPLAINT Info — <br /> COMPLAINT NODE: P PRONE <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Co,inter 4-Nail/Correspondence <br /> 0-Other ER Unit P-Pbon� <br /> COMPLAINT STATUS: <br /> 01-Field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate ls"jed 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File OT-Refer to Other Agency 08-Not Valid 09-Foodhorn� illness <br /> Send Referral Letter to: <br /> Address : <br /> Referral Letter Sent by: — Date : <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Foraarded to UNIT: 1 41 III IV for Investi^,,tion <br />