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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C�00040488 Site Location: 85 E LOUISE AVE Account ID: <br /> Received by: EE0000025 SEDRA Received Date: 1017/2015 Print Date. 10/7/2015 3:28:33PM <br /> Assigned To: EE0008709 DELAROSA Assigned Date: 10/7/2015 <br /> ftoramIELmot Qa&2546-Release/Spill Response(excluding Joint Team) <br /> Complainant: :SARAH SAMUELS-BP Home Phone <br /> Address WorkPhone <br /> -Mail Address <br /> Nature ofcomplaint: <br /> COMPLAINANT ALLEGES THAT ON 10!7/2015 AT 11:30 AM A CAR GAS TANK LEAKED ABOUT 1 GALLON OF 87 GRADE FUEL ONTO THE <br /> GROUND.FUEL HAS BEEN CONTAINED AND CLEANED UP. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> I-Intemet/Email S-Sheriff's Office <br /> --__---- <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner <br /> Site Location 85 E LOUISE RPiDBA <br /> LATHROP,CA 95330 RP Address <br /> Cross Street <br /> Billing Address <br /> Home Phone <br /> Phone Work Phone <br /> District Location Code <br /> APN <br /> Date Abated I/"�_-7_I 5 Inspector ID#: C) _7 O l <br /> ------------------------------------------ <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code:0 I <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 01-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 Reqired-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 MN-EHD Monitoring Status <br /> PD-Permit Issued-Pending Well Installation <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File RS-Resolved-New Well Installed <br /> 11-Multiple Complaints-SEE ACTIVE CASE a <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> plaint Reviewed y: pate by <br /> / - 14 <br /> eea i <br /> 5104 rpt <br />