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1 <br /> Complaint Investigation Form <br /> Report#:5104 <br /> COMPLAINT ID: C00032800 Site Location: 1111 NAVY DR AccountfD: AR0017514 <br /> Received by: EE0007541 FIELD Received Date: 10/25/2010 Print Date:10/25/2010 9:39:40AM <br /> Assigned To: EE0008317 VON FLUE Assigned Date: 10/25/2010 <br /> ProoramlFlement Code 2200-HAZARDOUS WASTE GENERATOR PROGRAM <br /> I <br /> Complainant: : HENRY Nome Phone 209-810-5209 <br /> Address : Work Phone <br /> E-MailAddress <br /> Nature of complaint. <br /> (C)STATED THERE IS A 5-GALLON CONTAINER SITTING ON A DIRT LOT NEAR A STORM WATER FILTER AT THIS ADDRESS. THE <br /> CONTAINER IS FULL OF USED OIL CONTAINERS. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral 8-Bd of Supervisors i City Council C-Counter F-Fax <br /> ' E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> Nnternet 1 Email S-Sheriffs Office <br /> ———— ——— — __ __ _ <br /> FACILITY INFORMATION — OWNER INFORMATION — — — <br /> Facility: FA0010514-ZACKY FARMS,LLC Owner: OW0008514-ZACKY,ROBERT f <br /> Site Location I 1 1 I NAVY DR RP/DBA ZACKY FARMS LLC <br /> STOCKTON,CA 95206 RP Address p0 BOX I2556 <br /> Cross Street FRESNO,CA 93778 <br /> Mailing Address: PO BOX 12556 Billing Address PO BOX 12556 <br /> FRESNO,CA 93778 FRESNO,CA 93778 <br /> Nome Phone <br /> Phone :209-948-6440 Work Phone <br /> District 001 -VILLAPUDUA Location Code 01 -STOCKTON <br /> APN 16326007 <br /> Date Abated f JJJ Inspector- <br /> -_ <br /> nspector. <br /> ——— <br /> ——— ________ __ __ __ <br /> Send Referral to Referral Letter Sent by — — — <br /> Referral Address Date: <br /> r <br /> Complaint Status Code: 0 <br /> Circle appropriate Status Code <br /> I <br /> 1 FIELD ABATED 50-LEAD Assessment Performed-No Abatement Required <br /> 2-OFFICE ABATED 52-LEAD Abatement Regired-See Program Record Fife <br /> 03-NAI SENT 97-Disaster Planning and Response <br /> 04-NOTICE TO ABATE ISSUED 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE CL-Case Closed <br /> 07-REFERRED TO OTHER AGENCY <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARDIUNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE A <br /> 12-DA Referred Complaint-See Violation Tracking Form <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 r <br /> x <br /> 1 <br /> 510 rpt <br />