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V/11A Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00051598 Site Location: 10331 N HWY 99 Account ID: <br /> Received by: EE0009825 AFONSKAIA Received Date: 2/7/2020 Print Date: 2/10/2020 9:20:59AM <br /> Assigned To: EE0009825 AFONSKAIA Assigned Date: 2/10/2020 <br /> Proaram/Element Code 4300-WELL PROGRAM <br /> Complainant: EHD Home Phone <br /> Address Work Phone <br /> E-Mail Address <br /> Nature of complaint: <br /> ABANDONED WELL. <br /> Complaint Mode: O 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 10331 N HWY 99 RP mailing address <br /> STOCKTON,CA 95212 <br /> Cross Street WALLER RD <br /> Mailing address RP contact <br /> RP contact phone <br /> Phone <br /> Property Owner:FELIX JAIMES <br /> DBA <br /> Owner address <br /> Billing Address 8712 LOS OLIVAS CT <br /> STOCKTON,CA 95210 <br /> Home Phone 209-298-4420 <br /> Work Phone <br /> District 002-MILLER,KATHERINE Location Code 99-UNINCORPORATED AREA <br /> APN 12203008 <br /> Date Abated �;L / Inspector ID#: <br /> '_ <br /> _ ——_ 111 -- -- _----_—_--- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> Field Response-Violations Cited and Corrected 29-Alleged FBI-Major Violations Identified <br /> 02 Office Response Only I Do 0 q V 9-7- 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 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 /> 1 <br /> omp aint Reviewed by: Date: /r I Updated by D <br /> 5104.rpt <br />