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CO0049238
EnvironmentalHealth
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4200 – Liquid Waste Program
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CO0049238
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Last modified
1/30/2023 10:04:21 AM
Creation date
2/11/2020 2:26:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
CO0049238
PE
4200
STREET_NUMBER
1914
Direction
N
STREET_NAME
AUTO
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
11921006
ENTERED_DATE
3/12/2019 12:00:00 AM
SITE_LOCATION
1914 N AUTO AVE
RECEIVED_DATE
3/12/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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Tags
EHD - Public
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. 11 Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00049238 Site Location: 1914 N AUTO AVE Account ID: <br /> Received by: EE0001420 NISSIM Received Date: 3/12/2019 Print Date: 3/12/2019 4:26:571'M <br /> Assigned To: EE0009488 WONG Assigned Date: 3/12/2019 <br /> Program/Element Code 4200-LIQUID WASTE PROGRAM <br /> Complainant: <br /> <br /> <br /> Nature of complaint: <br /> MOBILE HOME IS LEAKING GREY WATER. <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 INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Property Name: RP DBA <br /> Site Location 1914 N AUTO AVE RP mailing address <br /> STOCKTON,CA 95205 <br /> Cross Street WA"hERl.00 <br /> Mailing address RPcontact <br /> RP contact phone <br /> Phone <br /> Property Owner: IIONVARD&ANNE FAIRBANKS <br /> DBA <br /> Owner address <br /> Billing Address 813 E 950 S <br /> PROVO,UT 84606 � <br /> Home Phone S p , ' ® 11 <br /> Work Phone —� <br /> District 002-MILLER,KATHERINE Location Code 99-UNINCORPORATED AREA <br /> APN 11921006 <br /> Date Abated Z2t_ /Z 20 Inspector ID#: V v Dq" <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: (� I <br /> Circle appropriate Status Code ( ,L D � CV Od `T"t a� Q <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-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 Cornplaint-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 /> ornplaint Reviewedy: Date:^ p a e y: Qx ^ a e: <br /> b104 rpt AA (/ L.► <br /> G� <br />
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