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Complaint Investigation Form Report#: 5106 <br /> COMPLAINT ID: C00033660 Site Location: 3212 N CALIFORNIA ST Account ID: AR0003204 <br /> Received by: EE0009488 WONG Received Date: 6/7/2011 <br /> Assigned To: EE0009488 WONG Assigned Date: 6/7/2011 <br /> Location Code01 -STOCKTON <br /> Program/Element Code: 2200-HAZARDOUS WASTE GENERATOR PROGRAM <br /> Nature of complaint: <br /> 1/4 TO 1/2 GALLON OF GAS SPILLED ONTO CONCRETE FROM VEHICLE OVER FILING. SPILL CONTAINED ONSITE WITH 15 LBS OF <br /> ABSORBENT BY EMPLOYEE. <br /> Complaint Mode P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City C C-Countei E-Code Enforcemenl <br /> M-Mail/Correspondent O-Other Eld Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0003626-OAK PARK GAS&CONVENIENCE STORE OW0005490-VO, KHA Q <br /> RP DBA:OAK PARK GAS&CONVIANCE STORE <br /> Site Location: 3212 N CALIFORNIA ST <br /> RPAddress2207 N YOSEMITE ST <br /> STOCKTON, CA 95204 <br /> STOCKTON,CA 95204 <br /> Mailing Address 3212 N CALIFORNIA ST Billing Address2207 N YOSEMITE ST <br /> STOCKTON, CA 95204 STOCKTON, <br /> Phone 1st: 209-941-2694 Phone Hm: 209-948-2229 <br /> Wk: 209-941-2694 <br /> District 002-RUHSTALLER, LARRY Location: 01 -STOCKTON <br /> APN 12532001 <br /> * * * * * * * * * * * * * * * * * * * * * * * * ABATEMENT SUMMARY * * * * * * * * * * * * * * * * * * * ** * * <br /> Status Employee ID and Name Abatement Date <br /> 01 EE0009488-WONG,JEFFREY 6/7/2011 <br /> Abatement Status Codes <br /> 01-Field Abated 08-Unable to Verify 15-Active Haling Case-New Complaint-See Active Case 4 <br /> 02-Office Abated 10-POST®SubstandardUnsecued-See I-busirg File 28-FOODBOURi1,E ILiNESS—No Nlajor Violations Identified <br /> 03-NAI Sent 11-N><dtiple Carplaints-See Active Case# 29-F OODBOUNRE IU_NESS—N/hjor Violations Identified <br /> 04-Notice to Arte Issued 12-DA Referred Complaint-See Violation Tracking Forr50-LEAD Assessrne t Ierfarred—No Abaaerrerrt Re#red <br /> 0(5-EHD Pennit Facility-See Lied Facility File 52-LEADAbaterrni Recluired—See nvp=Reoord File <br /> 07-Referred to Other Agency 99-Liispecified—Old Complaint—Original not Available <br /> 5106.rpt <br />