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Complaint Investigation Form <br />Report* 5104 <br />COMPLAINT 10: C0003661Site Location: 22844 S FREDERICK RD <br />R—rviidby' EE0001421 RIVERA Received Date: 4/3012015 Print Date, 5/]','2015 9,17,06AM <br />Assigned To EE0001421 RIVERA Assigned Date. 4/3012015 <br />EM2w-5tA2MwL.Q'� <br />compiainant, <br />Address <br />Nattire of comnilaint: <br />THE SIDES OF A DIESEL TANK BLEIN OUT DURING FUEL DELIVERY, RELEASING APPROXIMATELY 6,000 G,'LLONS OF DIESEL ONTO THE <br />GROUND. <br />Cort lnt Mode: P complaint Mode codes A-AWCy Referral B -ad of Supervisors i City Cc i ural C-Cotinter F -Fax <br />E -Coda Enforcarrient M -Mail Y Correspondence O -Other Ei, U P -Phone <br />1-fritemet / Email 5 -Sheriffs Office <br />PRWERTY INP OWATION PROPERTY OWNER INFWWATION <br />f1rop" Name: Responsible Party or Property Owner: DAI." R & EJ KUIL <br />Site L=atbn 22W S FREDERICK RP108A , <br />RIPON, CA 95366 RP Address 22844 FREDERICK RI: <br />Cross Street W RIPON RIPON, CA 95366 <br />Billing Address 22844 S FREDERICK RI, <br />Ho— Phone 209-599-4960 <br />Phone Work Phone <br />District 005 - Eux)TT' BOB Location Code 99- LJN[NCORPORATEI.i AREA <br />APN 22813028 <br />Date Abated Inspector ID #.- <br />.. ........ ... .... . . .... . . .. . .. ......... ..... <br />send Referral to Referral Letter Sent by <br />Referral Address Date: <br />Complaint Status Code. 0-1 <br />Circle appropriate Status Code <br />10 - POSTED SUBSTANDARD/UNSECURED - See Housing File <br />I I - Multiple Complaints - SEE ACTIVE CASE # <br />12 - DA Referred Complaint -See Violation Trac*jng Form <br />77777 oate� I <br />!�—A' P,' <br />15 - ACTIVE HOUSING CASE - NEW CONIF AINT see ACTIVE CASE <br />Of - FIELD ABATED <br />28 - FOODBORNE ILLNESS - No Major Vick: ions iden0ed <br />02 - OFFICE ABATED <br />N - FOODBORNE ILLNESS - Major Violatloos Identified <br />03 - NAI SENT <br />50 - LEAD Assessment Performed -No Abate, ient Required <br />04 - NOTICE TO ABATE ISSUED <br />52 - LEAD Abatement Reqired-See Program I (ecord File <br />05 - DA - ENFORCEMENT ACTION INITIATED <br />97 - Disaster Planning and Response <br />06 - EHD FACILITY - see Linked PROGRAM FACILITY FILE <br />99 - UNSPECIFIED -Old Complaint -No Ofigirat Found <br />07•')REFERRED TO OTHER AGENCY <br />CL - Case Closed <br />08 - UNABLE TO VERIFY <br />10 - POSTED SUBSTANDARD/UNSECURED - See Housing File <br />I I - Multiple Complaints - SEE ACTIVE CASE # <br />12 - DA Referred Complaint -See Violation Trac*jng Form <br />77777 oate� I <br />!�—A' P,' <br />