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U, <br /> Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00051175 Site Location: 30000 KASSON RD Account ID: <br /> Received by: EE0001420 NISSIM Received Date: 11/12/2019 Print Date: 11/12/2019 1:42:50PM <br /> Assigned To: EE0000016 HO Assigned Date: 11/12/2019 <br /> Program/Element Code 1322-SUBSTANDARD HOUSING <br /> Complainant: ANNYMOUS Home Phone <br /> Address Work Phone <br /> Mail Address <br /> Nature of com laint: <br /> SITE-4134 WILLOW RD.70 YEAR OLD MAN LIVING IN FILTH WITH 1 FOOT OF GARBAGE AND MICE AND RATS. <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 /> ]-Internet/Email S-Sheriffs Office <br /> ------------------- ----------------------------- - <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Property Name: RP DBA <br /> Site Location 30000 KASSON RD RP mailing address <br /> TRACY,CA 95304 <br /> Cross Street <br /> Mailing address RP contact <br /> RP contact phone <br /> Phone <br /> Property Owner:LLOYD F DIAS <br /> DBA RIVER CLUB <br /> Owner address <br /> Billing Address <br /> <br /> Home Phone <br /> Work Phone <br /> District 005-ELLIOTT,BOB Location 99-UNINCORPORATED AREA <br /> APN 80402004 <br /> Date Abated L. L - � � Inspector ID#: �,i�ULJ a <br /> Send Referral to 1 l Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Coder <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 /> `8 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 /> omplaint Reviewed Dat Updated by::— Date:n7A �J <br /> 5104.rpt <br />