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,,. Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00033361 Site Location: 20801 S WOODWARD A Account 1D: AR0001051 <br /> Received by: EE0005838 ELLSAESSER Received Date: 3/2912011 Print Date: 3/29/2011 1 48:27PM <br /> Assigned To: EE0004045 TASIOPOULOS Assigned Date.• 3/29/2011 <br />-. 'Prooranr/Element Code:4200-LIQUID WASTE PROGRAM <br /> Complainant: : RON MURPHY Nome Phone 209-277-0040 <br /> Address Work Phone <br /> E-Mail Address <br /> Nature of com taint: <br /> (C)STATED SEWAGE WASTEWATER IS LEAKING FROM A SEWER LINE CONNECTION TO A COACH AND IS POOLING INA DITCH FOR THE <br /> WATER LINE. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter F•Fax <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> I-Intemet 1 Email S-Sheriffs Office <br /> - ------------------------------------------------ <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0001053-ISLANDER MARINA Owner: OW0000824-MARLOW,JOHN&MARIANNE <br /> Site Location 20801 S WOODWARD AVE RPIDHA ISLANDER MARINA <br /> MANTECA,CA 95336 RPAddress 750 LILAC LN <br /> Cross Street WOODWARD SACRAMENTO,CA 95864 <br /> Mailing Address: PO BOX 7537 Billing Address 750 LILAC LANE <br /> MENLO PARK,CA 94026 SACRAMENTO,CA 95864 <br /> Nome Phone <br /> e Phone Work Phone <br /> District 005-ORNELLAS,LEROY Location Code 99-UNINCORPORATED AREA <br /> APN 24125033 j <br /> Date Abated f————— Inspector. —————mm <br /> Send Referral to �V Referral Letter ent by <br /> Referral Address Date: <br /> Complaint Status Code: 1 <br /> Circle appropriate Status Code <br /> 1 FIELD ABATED 50-LEAD Assessment Performed-No Abatement Required <br /> o2-OFFICE ABATED 52-LEAD Abatement Regired-See Program Record File <br /> 03-NAI SENT 97-Disaster Planning and Response i <br /> 04-NOTICE TO ABATE ISSUED 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE CL-Case Closed <br /> 07-REFERRED TO OTHER AGENCY <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARDIUNSECURED-See Housing File ^ <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 29-FOODBORNE ILLNESS-Major Violations identified <br /> 04rpt <br /> Date: <br /> Inspector: <br /> Date: <br /> Inspector: <br /> I <br /> Date: <br /> Inspector: <br /> omp amt Reviewed by; �3u ate: pate y: Date: < <br /> 5104.rpt (�-� <br />