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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00016989 Site Location: 1434 W YOSEMITE AVE Account ID: AR0005072 <br /> Receivedby: EE0009903 WILSON Received Date: 1/5/2002 <br /> Assigned To: EE0009903 WILSON Assigned Date: 1/8/2002 <br /> ProgramlE/ement Code: 2547-GENERATOR RESPONSE STANDBY <br /> Complainant., Complainant Not Specified Home Phone: <br /> Address: Work Phone: <br /> Nature of complaint: <br /> GAS SPILL AT STATION,WAS WASHED TO SOIL AREA.CLEANUP STARTED. <br /> Complaint Mode A Complaint Mode Cotler: A-Agency Referral B-Bd of Supervisors/City Council E-Code Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0003739-JACKPOT FOOD MART` Owner: OW0001644-TIME OIL CO <br /> RP/DBA: _ <br /> Site Location: 1434 W YOSEMITE AVE RPAddress: 2737W COMMODORE WAY <br /> MANTECA,CA 95366 <br /> SEATTLE,WA 98199-1233 <br /> Mailing Address: 1434 W YOSEMITE AVE <br /> Billing Address:: 2737W COMMODORE WAY <br /> MANTECA,CA 95366 <br /> SEATTLE,WA 98199-1233 <br /> Phone: Phone: <br /> Wk: 209-462-3848 <br /> District 005-BEDFORD,LYNN Location Code 04-MANTECA <br /> APN <br /> Date Abated <br /> Inspector <br /> Send Referral to: 1:1 RLE COPY <br /> Referral Address: <br /> Referral Letter Sent by: completed <br /> Date: <br /> Complaint Status Code: <br /> L eQ_ <br /> 01-Field Abated _ 10-Substandard Property-See HOUSING ABATEMENT File <br /> 02-Office Abated JZ92- 15-Active Housing Case-New Complaint See Active Case# <br /> 03-NAI Sent16-Letter Sent To Tenant <br /> 04-Notice To Abate Issued I 17-15-Day Letter Sent <br /> 05-Enforcement Action Initiated 50-Lead Hazard Evaluation Required(1) <br /> 06-EHD Permit Facility-See Linked Premise File 52-Lead Hazard Abatement in Progress(3) <br /> 07-Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) .xfcaE� <br /> 08-Invalid/Unable To Verify 51-Lead Hazard Work Plan Submitted(2) Cp„' <br /> 09-Foodbome Illness 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> 11 -Multiple Complaints-See Active Case# 55-Lead Hazard Monitoring Schedule(6) <br /> 12-Enforcement Case-Transferred To LIQUID WASTE File 56-Lead Hazard Abatement Complete(7) -- 2 <br /> 13-Enforcement Case-Transferred To SOLID WASTE File 57-Lead Hazard Property Vacant W/Soil Contamination <br /> 14-Enforcement Case-Transferred To ER File 58-Lead Hazard Case-See Active File For This Site <br /> 0104.rpt <br />