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COMPLAINT # = C0011404 Program/Element : 4200 <br /> Taken by : 7824 GAGAZA Date: 12/17/98 Assigned to : 1699 YOAKUM Date: 12/17198 <br /> Hard copy Printed: 12/17/98 <br /> Facility Name : Fac ID: <br /> BILL to inventoried FACILITY: <br /> Location: .1.144.1...,.._L:AT.H.RO.P.....:R.P. (Must have FACILITY ID#) <br /> Complainant: <br /> : <br /> # ;ACit ITY LOCATION/Property Info — <br /> DBA or Nam, Cd <br /> _ -- — - <br /> Loc <br /> Address: 1444.. LATHROP RD _...- _ ....... SOS Dist <br /> City: APN # <br /> Phone . <br /> BILLING RESPONSIBLE PARTY or OWNER Info - <br /> Name ' ......................................................................................................................_......_......_._......._._..,._.._..............._......_..................,Home Phone <br /> Address ...................... ............ .......... ..........,.. ............. ...Work Phone: <br /> City : <br /> Nature Of COMDlaint: <br /> DRAINING SEWAGE OFF OF - TRAILER INTO DOCK . THEN GOES INTO STORM POND <br /> COMPLAINT Info — <br /> .COMPLAINT MODE: P PHONE <br /> A-Agency Referral B-BD OF SuQervisors/City Ccouncil C-Counter M-Mail/COT resPOndence <br /> 0-Other EH Unit P-Phore <br /> COMPLAINT STATUS: C7 Z <br /> 01-Field Abated 02- ffice Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise file 07-Refer to Other Agency 08-Not Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by: Date: <br /> Circle appropriate Unit A if complaint ' another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: 1 101 ' <br /> I III IV for Investigation <br />