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�p(V Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00041579 Site Location: 1990 N PICCOLI RD AccountlD: <br /> Receivedby: EE0000025 SEDRA Received Date: 5/23/2016 Print Date: <br /> Assigned To: EE0000005 ZAREEF 5/23/2016 3:42:2SPM <br /> Assigned Date: 5/23/2016 <br /> EMg__ram/Element Codi-Release/Spill Response(excluding Joint Team) <br /> Complainant: :THELMA SASS Home Phone <br /> Address <br /> ' Wonr Phone <br /> -Mail Address <br /> Nature of corn /aint: <br /> ON 5/23/2016 AT APPROXIMATELY 11:45 AM A PALLET OF BLEACH WAS DROPPED SPILLING APPROXIMATELY 20 GALLONS ONTO THE <br /> CEMENT FLOOR IN THE WAREHOUSE. NO DRAINS OR WATERWAYS WERE IMPACTED.NRC WAS NOTIFIED AND A THIRD PARTY IS ON <br /> THE WAY TO CLEAN UP. <br /> Complaint Mode: P Complaint Mode Cotles 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 /> ______________ 1-Internet/Email S-Sheritrs Office <br /> -------------------------------- <br /> PROPERTY INFORMATION <br /> PROPERTY OWNER INFORMATION <br /> Property Name:UNIFIED GROCERS INC Responsible Party or Property Owner <br /> Site Location 1990 N PICCOLI RP/DBA UNIFIED GROCERS INC <br /> STOCKTON,CA 95215 RP Address 1990 N PICCOLI RD <br /> Cross Street CHEROKEE STOCKTON,CA 95215 <br /> Billing Address 1990 N PICCOLI RD <br /> Home Phone <br /> Phone Work Phone <br /> District 004-WINN,CHARLES Location Code 99-UNINCORPORATED AREA <br /> APN 10121001 96 14. 11 <br /> --- -- <br /> Date Abated Inspector ID###: <br /> _— --- !9 <br /> al--nt -------- <br /> Send Referral to Referral Lefler Sent byy ------_ <br /> Referral Address <br /> Date: <br /> Complaint Status Coder <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE It <br /> 01-Field Response-Violations Cited and Corrected 28-Alleged FBI-No Major Violations Identified <br /> -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-Referred 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 /> ompaint Reviewed by: ate: �j -7 <br /> /;_Z Updated y: at <br /> 51o4.rpt <br />