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V_\ Complaint Investigation Form <br /> COMPLAINT ID: C000 <br /> 44805 Site Location: 3p2g NAV? <br /> Receivedby: EE0000035 DR Report#:5104 <br /> Assigned HERNANDEZ Account ID. <br /> 9 To: EE0000031 FLORIDO ReceivedD <br /> ate: 10/23/2017 <br /> p r / ent d 2548_NonRelRes Assigned Date: 10/23/2017 Pnnt Date: <br /> Complainant: Ponse-Haz 10/23/2017 2:45:03PM <br /> JORDAN CAIN-PACIFIC ETHANOL t/Chemical pickup <br /> Address <br /> Home Phone : 209-851-4077 <br /> Nature of Coro Wonr Phone <br /> la%nt: -MdllAddress <br /> 1,000 GALLON OF CORN OIL SPILL. IN PR( <br /> OF CLEAN UP. <br /> NO <br /> Complaint ModeIMPACT To WATER <br /> . p WAY. <br /> Complaint Mode Codes <br /> A-Agency Referral <br /> B-Bd of Supervisors/City Council <br /> — O--__ E-Cotle Enforcement M-Mail/Correspondence O-Other E <br /> PROPERTYINFORMATION ----I--�ntemet/Email c-coup r F.F <br /> ———— S-Sheriffs Office H Unit \ p.phone <br /> Property Name: PROPERTY OWNER INFORMATION <br /> Site Location 3028 NAVY Responsible P <br /> STOCKTON, any or Property Owner <br /> CA 95203 RPrDBA rN <br /> Cross Street RPAddress Y <br /> Billing Address <br /> Phone : Home Phone <br /> District001-WLLAPUOUA,CARLOS Work Phone <br /> APN 14502018 Location Code 01-STOCKTON / <br /> Date Abated ! 1 /-2-7 <br /> h ^ <br /> ------------I�—+ I� Inspector ID#: OU3I � FIOYi�(7 <br /> Send Refenal to ---------------- <br /> ReferrdlAdoreAdtlress Referral Letter Sent by <br /> Date: <br /> Complaint Status Code_ 01 <br /> uncle appropriate Status Code <br /> I- field Response-Violatians Cited and Corrected <br />.-Office Response OrYy 50-LEAD Assessment Performed-NOA6atement Requiretl n <br />-Violations Cited-see LX*ed PROGRAM FACILITY FILE 52-LEAD Abatement Reqired-See Program Record File <br />-Refferred to OtherAgen y 97-Disaster Planning and Response \� \ <br />-Unable to Verify Allegeo Complaint 99-UNSPECIFIED-Old Complaint-No Original Found <br />-POSTED SUBS7ANDARDAINSECURED- MN-EHD Monitoring Status <br /> See Housing F7e <br /> PD-permit Issued-Pending Well Installation <br /> Multiple Complaints-SEE ACTIVE CASE# ^, <br /> DA Referred Complaea.See RS-Resolved-New Well Installed <br /> Program Enforcement Action Form <br /> CTIVE HOUSING CASE_NEW COMPLAINT see ACTIVE CASE# S1-Tank pumped <br /> Ileged FBI-No S2-Hooked up to public sewer <br /> Mehr Nidations Identified <br /> eged FBI-Major Vidatipts Identified S3-Septic system repaired <br /> r <br /> vlewe y: <br /> / /� <br /> LP ate y: <br /> ate: <br /> U i <br />