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CO0015091
EnvironmentalHealth
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4300 - Water Well Program
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CO0015091
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Entry Properties
Last modified
1/12/2026 9:21:57 AM
Creation date
1/12/2026 9:07:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
CO0015091
PE
4300 - WELL PROGRAM
FACILITY_ID
FA0002062
FACILITY_NAME
Big Lots Stockton 1916
STREET_NUMBER
2720
STREET_NAME
COUNTRY CLUB
STREET_TYPE
DR
City
Stockton
Zip
95204
ENTERED_DATE
10/24/2000 12:00:00 AM
CURRENT_STATUS
Referred
SITE_LOCATION
2720 COUNTRY CLUB BLVD
RECEIVED_DATE
10/24/2000 12:00:00 AM
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\bmascaro
Supplemental fields
FilePath
\MIGRATIONS\C\COUNTRY CLUB\2720\CO0015091.PDF
Site Address
2720 COUNTRY CLUB BLVD STOCKTON 95204
Tags
EHD - Public
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+ Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00015091 Site Location: 2720 COUNTRY CLUB BLVD Account ID: AR0002070 <br /> Received by: EE0005838 ELLSAESSER Received Date: 10/24/2000 ?D 3 ` J�3Yr <br /> Assigned To: EE0005838 ELLSAESSER Assigned Date: 10/24/00 <br /> Program/Element Code: 4300-WELL PROGRAM i <br /> <br /> <br /> Nature of complaint: <br /> OPEN WELL CASING. PACKED WITH DIRT IN FRONT PARKING LOT OF NEW CONSTRUCTION SITE. : <br /> Complaint Mode A Complaint Mode Codes: A-Agency Referral B-Bd of Supervisors/City Council! E-Code Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0002062-SAFEWAY MARKET&BAKERY#4159 Owner: OW0000429-SAFEWAY INC <br /> RPIDBA: <br /> Site Location: 2720 COUNTRY CLUB BLVD, <br /> STOCKTON,CA 95204 RP Address: 47400 KATO RD <br /> FREMONT,CA 94537 <br /> Mailing Address: PO BOX 29096 <br /> Billing Address:: PO BOX 29096 <br /> PHOENIX,AR 85038-9096 PHOENIX,AR 85038-9096 <br /> Phone: 1st: 209-239-9327 Phone: Hm: 209-239-9327 ././ (� <br /> Wk: 209-239-9327 ��°�a 1,3 <br /> 3 OP <br /> District 001 -GUTIERREZ,STEVE Location Code 99-UNINCORPORATED AREA <br /> APN ^ <br /> Date Abated j <br /> Inspector (((/// 5 a <br /> Send Referral to: <br /> Referral Address: <br /> i <br /> I H�. <br /> Referral Letter Sent by :iI <br /> Date: <br /> Complaint Status Code; <br /> 01 -Field Abated 10-Substandard Property-See HOUSING ABATEMENT File <br /> 02-Office Abated 15-Active Housing Case- New Complaint See Active Case# <br /> 03-NAI Sent 16- Letter Sent To Tenant <br /> 04-Notice To Abate Issued 17- 15-Day Letter Sent <br /> 05-Enforcement Action Initiated 50- Lead Hazard Evaluation Required(1) <br /> 06- EHD Permit Facility-See Linked Premise File 52- Lead Hazard Abatement in Progress(3) <br /> __07- Referred To Other Agency 53- Lead Hazard Visual Inspect Satisfactory(4) <br /> 08- Invalid/Unable To Verify 51 -Lead Hazard Work Plan Submitted(2) <br /> 09- Foodborne Illness 54- Lead Hazard Dust Evaluation Satisfactory(5) <br /> 11 -Multiple Complaints-See Active Case# 55-Lead Hazard Monitoring Schedule (6) ! ] <br /> 12- Enforcement Case-Transferred To LIQUID WASTE File 56- Lead Hazard Abatement Complete (7) <br /> 13-Enforcement Case-Transferred To SOLID WASTE File 57- Lead Hazard Property Vacant WIS oil ContaminationI O tr <br /> 14-Enforcement Case-Tra nsferred To ER File 58- Lead Hazard Case-See Active File For This Site J <br /> s"N, <br /> 0104.rpt <br />
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