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Phone : 209-931-2983 <br />District 002- MILLER, KATHERINE <br />APN 08709016 <br />Date Abated <br />Location Code <br /> <br />L f\t"\ .3omplaint Investigation Form Report #: 5104 <br /> <br />a\ " <br />COMPLAINT ID: C00040094 Site Location: 4350 CHEROKEE RD <br /> <br />Account ID: AR0002321 <br /> <br />Received Date: 7/29/2015 Print Date: 7/29/2015 12:29:16PM <br />Assigned Data: 7/29/2015 <br />Received by: EE0007380 SHIH <br />Assigned To: EE0009488 WONG <br />Program/Element Code:3600 - RECREATIONAL HEALTH PROGRAM <br />Complainant: : JOHN LIRA (SPACE #25) <br />Address <br />Home Phone <br />Work Phone <br />t-Mall Address <br />: 209-487-4646 <br /> <br />Nature of complaint: <br />REFERRAL FROM STATE DRINKING WATER DIVISION, POOL WATER IS BAD AND POOL IS CLOSED. <br />Complaint Mode: p Complaint Mode Codes A-Agency Referral <br />E-Code Enforcement <br />I-Intemet / Email <br />B-Bd of Supervisors / City Council <br />M-Mail / Correspondence 0-Other EH Unit <br />S-Sheriffs Office <br />C-Counter <br />P-Phone <br />F-Fax <br />FACILITY INFORMATION OWNER INFORMATION <br /> <br />Facility: FA0002308 - COUNTRY SQUIRE MOBILE ESTATES & WATER <br /> <br />Owner: OW0001782 - CTC INVESTORS <br />SYSTENtite Location <br />Cross Street <br />Mailing Address: <br />4350 CHEROKEE RD <br />STOCKTON, CA 95215 <br />CHEROKEE <br />PO BOX 1548 <br />OAKDALE, CA 95361 <br />RP/DBA <br />RP Address <br />Billing Address <br />Home Phone <br />Work Phone <br />151 CALIFORNIA AVE <br />OAKDALE, CA 95361 <br />PO BOX 1548 <br />OAKDALE, CA 95361 <br />: 209-845-3836 <br />: 209-845-3835 EXT: FAX <br />Inspector ID #: <br />Send Referral to <br />Referral Address <br /> <br />Referral Letter ent by <br />Date: <br /> <br />Complaint Status Code: O <br />Circle appropriate Status Code <br />01 - FIELD ABATED <br />02- OFFICE ABATED <br />03 - NAI SENT <br />NOTICE TO ABATE ISSUED <br />DA - ENFORCEMENT ACTION INITIATED <br />06 - EHD FACILITY - see Linked PROGRAM FACILITY FILE <br />REFERRED TO OTHER AGENCY <br />UNABLE TO VERIFY <br />10- POSTED SUBSTANDARD/UNSECURED - See Housing File <br />11 - Multiple Complaints - SEE ACTIVE CASE # <br />12- DA Referred Complaint-See Violation Tracking Form <br />1700 I re, 6k_Cf C( SQ-S- <br />1-vli ctiii <br />tijk <br />15 - ACTIVE HOUSING CASE - NEW COMPLAINT see ACTIVE CASE # <br />28- FOODBORNE ILLNESS - No Major Violations Identified <br />29 - FOODBORNE ILLNESS - Major Violations Identified <br />50- LEAD Assessment Performed-No Abatement Required <br />52- LEAD Abatement Reqired-See Program Record File <br />97 - Disaster Planning and Response <br />99- UNSPECIFIED-Old Complaint-No Original Found <br />CL - Case Closed <br />cr E411) <br />(0-4 cculteS_ (c) 174 <br />Updated by: Date: omplaint Reviewed by: Date: