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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00039351 Site Location: 2072 W YOSEMITE AVE Account ID AR0041982 <br /> Received by EE0001422 VELOSO Received Date: 3/12/2015 Print Date: 5/8/2015 10:31:17AM <br /> Assigned To: EE0001422 VELOSO Assigned Date: 3/12/2015 <br /> Program/E/ement Code.2546-Release/Spill Response(excluding Joint Team) <br /> Complainant: : PIERRE CHAHOUD Home Phone 209-824-6700 <br /> Address :2072 W YOSEMITE AVE Work Phone <br /> STOCKTON,CA 95337 E-Mail Address <br /> Nature of complaint: <br /> ELITE IV TECHNICIAN CHRIS ADAMS SPILLED APPROXIMATELY 7.5 GALLONS OF FUEL FROM THE HOSE AT DISPENSER#7 DUE TO PIERRE <br /> CHAHAUD TURNING ON THE FUEL TURBINE/ACTIVATING THE DISPENSER WHILE IT WAS BEING WORKED ON BY CHRIS. <br /> Complaint Mode. P Complaint Mode Codes 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 /> I-Intemet/Email S-Sheriffs Office <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner,PIERRE CHAHOUD <br /> Site Location 2072 W YOSEMITE RP/DBA QUICK STOP <br /> MANTECA,CA 95367 RP Address 2244 RYANLEE DR <br /> Cross Street AIRPORT WAY RIVERBANK,CA 95637 <br /> Billing Address 2244 RYANLEE DR <br /> Home Phone <br /> Phone Work Phone <br /> District Location Code <br /> APN <br /> Date Abated '� Inspector ID#: � <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 01-FIELD ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 02-OFFICE ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 03-NAI SENT 50-LEAD Assessment Performed-No Abatement Required <br /> 04-NOTICE TO ABATE ISSUED 52-LEAD Abatement Reqired-See Program Record File <br /> 05-DA-ENFORCEMENT ACTION INITIATED 97-Disaster Planning and Response <br /> 06- HD FACILITY-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-REFERRED TO OTHER AGENCY CL-Case Closed <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> ompaint Reviewed by Da e. Updated by Date <br /> 5104 rpt <br />