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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: COLLW66CY Site Location: 6425 N Pacific Ave Account ID: <br /> Received by: EE0000032 ALANIZ Received Date: 5/13/2019 Print Date: 5/13/2019 2:02:57PM <br /> Assigned To: EE0000032 ALANIZ Assigned Date: 5/13/2019 <br /> Program/Element Code 2546-Release/Spill Response(excluding Joint Team) <br /> Complainant: <br /> <br /> <br /> Nature of complaint: <br /> rhas <br /> oximately 3-4 gallons of unleaded gasoline was released,due to unknown reasons, impacting the concerete pad of a service station. The release <br /> been stopped and it was cleaned by service station personnel. No waterways were impacted. <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 /> 1-Internet/Email S-Sheriffs Office <br /> --------------------------------------------------- <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Property Name: RP DBA Safeway,Inc. <br /> Site Location 6425 N Pacific AVE RP mailing address <br /> <br /> <br /> <br /> <br /> Phone <br /> Property Owner:LINCOLN PROPERTIES LTD ETAL <br /> DBA <br /> Owner address <br /> Billing Address 1371 OAKLAND BLVD#200 <br /> WALNUT CREEK,CA 94596 <br /> Home Phone <br /> Work Phone <br /> District Location Code <br /> APN <br /> Date Abated � ) J q Inspector ID#: A <br /> ——— ——— 1�—f——— ———--------—--------------------- <br /> Send <br /> -- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code <br /> Circle appropriate Status Code 1 <br /> 01-Field Response-Violations Cited and Corrected 29-Alleged FBI-Major Violations Identified <br /> 02-Office Response Only 50-LEAD Assessment Performed-No Abatement Required <br /> L0 --Violations Ci e -s e inked PROGRAM FACILITY FILES 52-LEAD Abatement Reqired-See Program Record File <br /> 07-Referred to Other Agency 97-Disaster Planning and Response <br /> 08-Unable to Verify Alleged Complaint 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File MN-EHD Monitoring Status <br /> 11-Multiple Complaints-SEE ACTIVE CASE# PD-Permit Issued-Pending Well Installation <br /> 12-DA Referred Complaint-See Program Enforcement Action Form RS-Resolved-New Well Installed <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S1-Tank pumped <br /> 28-Alleged FBI-No Major Violations Identified S2-Hooked up to public sewer <br /> omp aint Reviewed pate y: <br /> 5104.rpt <br />