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State of California California Environmental PrctectionAcency Department of Toxic Substances Control <br /> ENVIROSTOR COMPLAINT FORM CAL EPA COMPLAINT ID#:11992 CASE #: 13-0913-0622 <br /> Is this an emergency? N Is this a spill? N <br /> Complaint Intake: <br /> How Complaint Was Received: CALEPA Online Complaint System <br /> Received By: Date Received:9/3/2013 Time Received: 03 14 PM <br /> Notification Made Regarding Prop 65: N <br /> Local Agency Notified: Who Notified at Local Agency: <br /> Complainant Information: <br /> Contact Name: Tiffany Anderson Agency: <br /> Address: <br /> 2 N Avena Avenue <br /> Lodi, CA 95240 <br /> San Joaquin County <br /> Contact Phone: 2096258587 Contact Email: tiffanyanderson@me.com <br /> Complaint Description: <br /> Complaint Related To:Air(ARB), Garbage(CIWMB), Pesticides(DPR), Toxics(DTSC),Water(SWRCB), Prop 65(OEH <br /> Date of Occurrence:4/1812006 Time Received: Unknown Onging: Unknown <br /> Complaint Focus: Other <br /> Complaint Description: <br /> Response Type ! Date: 9/612013 <br /> Referred To: San Joaquin County Environmental Health- Kasey Foley-kfoley@sjcehd.com <br /> Generated by EnviroStor-hlip flwww envirostor dtsc ca gov PDF Generated on 9/6/2013 2 50:37PM <br />