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Complaint Investigation Summary Report #: 5105 <br />COMPLAINT ID: C00055469 Site Location: 1201 E MINER AVE <br /> <br />Received by: EE0002089 SOOD <br />Received Date: 1/4/2023 <br />Complaint Received Via: AGENCY REFERRAL <br />Assigned To: EE0002089 SOOD <br />Assigned Date: 1118/2023 <br />Program/Element Code 1252 - Lead Abatement-Borderline Case <br />Nature of complaint: <br />BORDERLINE CASES (SIBLINGS) STATE ID #8118096 AND STATE ID #6916847 <br />PROPERTY INFORMATION <br />Facility: FA0027492 - DANA SHAULES TR <br />Site Location 1201 E MINER AVE District <br />001 - VILLAPUDUA, MIGUEL <br />STOCKTON, CA 95205 <br />Location Code 01 - STOCKTON <br />Cross Street PILGRIM <br />APN <br />15112031 <br />Complaint Status: S 2- <br />Date Abated: Abated By: C/Sco t2-ecc- <br />Activity Summary <br />Activity Date Recorded by <br />01/03/2023 PHN REFERRAL. REVIEW WITH PHN. SOOD <br />01/03/2023 ENVIRONMENTAL INVESTIGATION. SOOD <br />01/03/2023 Risk assessment with Omran, family, and maintenance person. SANGALANG <br />01/04/2023 REVIEW WITH PHN. SOOD <br />01/04/2023 PREPARE SAMPLES. CDPH-CLPPB LPFFS. SOOD <br />01/04/2023 CHAIN OF CUSTODY FORMS. DROP OFF SAMPLES AT UPS. SOOD <br />01/05/2023 FILE CONSTRUCTION. SOOD <br />01/06/2023 RECEIVED AND REVIEWED LABORATORY RESULTS. CDPH-CLPPB LPFFS. SOOD <br />REVIEW WITH FAMILY AND PHN. <br />01/06/2023 REVIEW FILE. CDPH-CLPPB LEAD HAZARD EVALUATION REPORT. SOOD <br />CDPH-CLPPB LPFFS. <br />01/09/2023 REVIEW FILE. AMEND CDPH-CLPPB LEAD HAZARD EVALUATION REPORT. SOOD <br />CDPH-CLPPB LPFFS. COPY TO CDPH-CLPPB. <br />03/02/2023 AN ENVIRONMENTAL INVESTIGATION WAS CONDUCTED ON 1/3/23. LEAD SOOD <br />HAZARDS WERE IDENTIFIED AND LEAD ABATEMENT WORK REQUIRED. <br />SEE PROGRAM RECORD FILE PR0548182. <br />5105 rpt Page 1 of 1