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`;NA Complaint Investigation Form Report* 5104 <br /> COMPLAINT ID: C00043200 Site Location: 1990 N PICCOLI RD Accounth): <br /> Receivedby: EE0000012 MARTORELLA Received Date: 4/3/2017 Print Date: 4/3/2017 9:34:49AM <br /> Assigned To: EE0000006 SAEED Assigned Date: 4/3/2017 <br /> P10gmm/Element Code:2546-Release/Spill Response(excluding Joint Team) <br /> Complainant: :THELMA SASS,ENV HEALTH&SAFETY MANAGER Home Phone <br /> Address Work Phone <br /> -Mail Address <br /> Nature of complaint: <br /> APPROXIMATELY 180 GALLONS OF BLEACH SPILLED ON IAM,4/3/2017.CONTAINED TO WAREHOUSE,NO OUTSIDE SEEPAGE. <br /> THIRD-PARTY CLEAN-UP BEING DONE. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors I City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail I Correspondence O-Other EH Unit P-Phone <br /> I-Internet/Email S-Sheriffs Office <br /> ---------------------------- - - - - - - ------- <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name:UNIFIED GROCERS INC Responsible Party or Property Owner <br /> Site Location 1990 N PICCOLI RPIDBA UNIFIED GROCERS INC <br /> STOCKTON,CA 95215 RP Address 18818 TELLER AVE STE 277 <br /> Cross Street HWY 99 IRVINE,CA 92612 <br /> Billing Address 18818 TELLER AVE STE 277 <br /> Home Phone <br /> Phone Work Phone <br /> District 004-WINN,CHARLES Location Code 99-UNINCORPORATED AREA <br /> APN 10121001 <br /> Date Abated C 17:31 <br /> � Inspector ID#: rte/ <br /> J L nn <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Coder <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 01 Field Response-Violations Cited and Corrected 28-Alleged FBI-No Major Violations Identified <br /> 02-Office Response Only 29-Alleged FBI-Major Violations Identified <br /> 50-LEAD Assessment Performed-No Abatement Required <br /> 52-LEAD Abatement Reqired-See Program Record File <br /> 97-Disaster Planning and Response <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-Reffer ed to Other Agency <br /> 08-Unable to Verify Alleged Complaint 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 /> rompaint Reviewedy: te. pate <br /> Z Y tel 5104.mt <br />