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public Mahn Services Environmental. H.talth Division HOTJSING ABATEMENT PROGRAM ENFORCEMENT CHECKLIST NOTICE AND ORDER TO ABATE 1. -10 r o3 Date Complaint Received and Complaint edNo. 2 _ p -o Date Notice and Order to Abate 3Date Posting of Affidavit Completed ,� �—Notice to Secure Posted 5 Notice to Secure Letter Mailed 6 Compliance Date to Secure Structure(s)HR Ni 7. 3- Entered into SIERRA Sy 8 M Z .�> Date Title Search Orderedeal Forms, and 9. Date Title Search Received PP �r z.-�3 Date Notice and Order Mailed Certified to Owner�� Cover Letter, s la �� Lead Hazard Notice les with Cover Letter,Appeal Forms, 11. Date Notice and Order Mailed Certified to Beneficiary ) ah the EHD `_`�' and Lead Hazard Notice Date Notice of Abatement Action Sent to the Office of the Recorder through 12. �. Accounting Office Date Septic Tank Destroyed and Permit Finaled(Mark no we 1)o septic tank) 13. �—D P ark NI 14 Date Well Destroyed and Permit Finaled (Mark NIA if no well) 15. Date Out of Service Well Perm Obtained from Office of the Recorder 16 � Date Notice of AbatementDocument No. Date Recorded 17 --.Date Abated: No. of Structures Demolished No. of Structures Repaired REHS Staff Signature Supervisor's Signature APPEAL OFNOTICEAND ORDER TO ABATE 18 Date Appeal of Notice and Order Received Date Notice of Appeal Hearing Posted Hearing Notice) 19. ____— Completed(For 20. ----Date Posting Affidavit 21. Date of Appeal Hearing 22. ----Date BHA Resolution Posted leted(For BHA Resolution) Appellant(s) Date Posting Affidavit Comp Beneficiary{ies) and/or App 23. � — tic tank) Date Resolution Mailed Certified to Owners 24. E Date Septic Tank Destroyed and Permed ina�k(Mark�no well) sep 25. �. 26 � Date Well Destroyed and permit Fmk ark NIA if no well) Date Out of Service Well Permit Obtained(M 27. �� 28 � Date Abated: No. of Structures Demolished No. of Structures Repaired�� REHS StafI Signature Supervisor's Signature 9a2e 1 of 3