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Complaint Investigation Form Report#:5104 <br /> COMPLAINT D: C00035956 Site Location: 1111 NAVY DR AccountlD: AR0017514 <br /> Receivedk, EE0004636 BACKUS Received.Date: 2/4/2013 Print bate: 2/4/2013 10:21:33AM <br /> Assigned To: EE0004636 BACKUS Assigned Date: 2/4/2013 <br /> Program/Element Code:2547-Release Response STANDBY <br /> Complainant: .:STOCKTON FIRE-VAN RIVIERE FIRE BATTALION CHIEF Home Phone <br /> Address Work Phone <br /> -Mail Address r <br /> ;- Nature of complaint: <br /> AMMONIA LEAK FROM REFRIGERATION EQUIPMENT <br /> Complaint Made: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail!Correspondence O-Other EH Unit P-Phone <br /> I-Internet 1 Email, S-Sheriffs Office <br /> ---- ----- -- --------- ------ --FACILITY INFORMATION OWNER INFORMATION <br /> 1 Facility:FA0010514-ZACKY FARMS,LLC Owner: OW0008514-ZACKY FARMS LLC <br /> Site Location 1111 NAVY DR RP/DBA ZACKY FARMS LLC <br /> I STOCKTON,CA 95206 RPAddress PO BOX 12556 <br /> + Cross Street CHARTER WAY FRESNO,CA 93778 <br /> 4 Mailing Address: PO BOX 12556 Billing Address PO BOX 12556 <br /> FRESNO,CA 93778 FRESNO,CA 93778 <br /> Nome Phone <br /> Phone :209,-948-6440 Work Phone <br /> iDistrict ' Location Code <br /> APN <br /> Date Abated _7 Z�r 3 Inspector ID#.-. �G s <br /> Send Referral to 7 Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> FIELD ABATED 15._ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 02-OFFICE ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 03-NAI SENT 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 04-NOTICE TO ABATE ISSUED 50-LEAD Assessment Performed-No Abatement Required <br /> 05-DA-ENFORCEMENT ACTION INITIATED 52-LEAD Abatement Regired-See Program Record File <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> [ 07-REFERRED TO OTHER AGENCY 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 11f 08-UNABLE TO VERIFY CL-Case Closed <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 5104.rpt - <br />