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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00050384 Site Location: 1121 S ANNABELLE LN Account ID: <br /> Received by: EE0001420 NISSIM Received Date: 8/28/2019 Print Date: 8/28/2019 9:56:51AM <br /> Assigned To: EE0009819 BENIAMINE Assigned Date: 8/28/2019 <br /> Proaram/Element Code 1322-SUBSTANDARD HOUSING <br /> Complainant: <br /> <br /> <br /> Nature of complaint: <br /> 1138 S ORO HAD FIRE IN ATTIC. PG&E PULLED METERS. <br /> Complaint Mode: A 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-Internet/Email S-Sheriffs Office <br /> ------------------------------------------------- <br /> PROPERTY <br /> ------------------------------------------------ <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Property Name: RPDBA <br /> Site Location 1121 S ANNABELLE LN RP mailing address <br /> STOCKTON,CA 95215 <br /> Cross Street MAIN <br /> Mailing address RP contact <br /> RP contact phone <br /> Phone <br /> Property Owner:3 STAR INVESTMENTS LLC <br /> DBA HB Q – Z � <br /> Owner address �—��� <br /> Billing Address PO BOX 8871 <br /> STOCKTON,CA 95208 <br /> Home Phone <br /> Work Phone <br /> District 002-MILLER,KATHERINE Location Code 99-UNINCORPORATED AREA <br /> APN 17320012 <br /> Date Abated Inspector ID#: elw GW?,1t4^P� <br /> ------------------------------------ <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <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 /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 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- OSTED SUBSTANDARD/UNSECURED-See Housing File!I�lJ�� O r 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 amt Reviewed by: Yl ate: , Updated y: 1. <br /> 5104.rpt <br />