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TOXIC' �U13STFhlCE� CONTROL 4 912t39ab401-'J0 <br /> �1/26r9� 113:19 s <br /> t� ' pFot, ybetan <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> one) county <br /> COMPLAINT DATA <br /> Is this an emergency? ❑ Yes 'Na If yes. call the Office of finergenI Services (OES): 8()0-852-7660 <br /> Loft Nurnbar::L "l tlate Cumpfalnt Received: 1112 Tlme: <br /> . Received 13y: <br /> Notifications toads(YefstiNo) Prop. 85 Local Agency Who? <br /> � Alla�atfon ty'ods�: � Qu$ntit�►: <br /> Date of Incident: 4 <br /> TypetGanditipn of Cawd"ef's Visible'_ <br /> Source off Corrrplafnticode`: -If Cade A, SpecltY- <br /> Other Comments: <br /> a s <br /> x1111 _ <br /> COMPLAINT COORDINATORS ONLY <br /> Response Gods': Reglon1AaoncY ft <br /> f&m@d T0: <br /> :T — <br /> Reeporew Date., fnvesftpatfir: Outs Awdu d.- <br /> iota' 1n(armaum to na tran$f9rred to comPlQlnt tag in nlampion in maid nmile Punt_Attach HA XMBlltlllm h n0eae88q. <br /> See rode an ravarse aide. <br /> Whit"isgionelOffice Voilow—�-Lcg Pink— nventigetiona Green—Informen <br /> Urac 1017(10rao as vim <br /> wsrmarlr ONS 8231 ane 0119 ani* <br />