Laserfiche WebLink
Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00040581 Site Location: 6425 N PACIFIC AVE Account ID: : <br /> Receivedby: EE0003600 BLACKWELL Received Date: 10/26/2015 <br /> Assigned To: EE0008709 DE LA ROSA Assigned Date: 10/26/2015 Pnnt Date: 10/27/2015 922:11AM <br /> Pmorem/Element Code:2546-Release/Spill Response(excluding Joint Team) <br /> Complainant: :STATE WARNING CENTER-KATIE GOMEZ-SOLVE ONE Home Phone <br /> Address <br /> Work Phone <br /> -Mail Addmss <br /> Nature of complaint: <br /> RESPONSIBLE PARTY STATED A CUSTOMER OVERFILLED THEIR GAS TANK,WHICH RESULTED IN THE RELEASE OF 1 GALLON OF <br /> GASOLINE ONTO THE GROUND.THE RELEASE IS CONTAINED AND CLEANUP IS COMPLETE.NO WATERWAYS WERE IMPACTED. <br /> Complaint Mode: A Complaint Mode Cotles A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement Ill/Correspondence O-Other EH Unit P-Phone <br /> ____________________I-Intemet/Email S-Shedfrs Office <br /> _—_—_—_--_— _----____ <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name:SAFEWAY FUEL CENTER Responsible Party or Property Owner <br /> Site Location 6425 N PACIFIC RP/DBA <br /> SAFEWAY INC <br /> STOCKTON,CA 95207 RP Address 5918 STONERIDGE MALL RD <br /> Cress Street DOUGLAS PLEASANTON,CA 94588--322 <br /> Billing Address 5918 STONERIDGE MALL RD <br /> Home Phone <br /> Phone Work Phone <br /> District 002-MILLER,KATHERINE Location Code 01-STOCKTON <br /> APN 09741031 <br /> ---Date Abated 10-up-1G ------Inspector/D#: <br /> , J __—_—_—_--_ — _ <br /> Send Referral to Referral Letter Sent by <br /> Referral Address <br /> Date: <br /> Complaint Status Code: !lI <br /> Circle appropriate Status Code <br /> l l <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# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> ompalnt Reviewed by: n 1 p 1 <br /> atepdated b <br /> ate <br /> 5104.mt 1 <br />