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CO0006953
Environmental Health - Public
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4200 – Liquid Waste Program
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CO0006953
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Entry Properties
Last modified
11/4/2019 3:03:34 PM
Creation date
2/8/2019 6:49:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
CO0006953
PE
4200
STREET_NUMBER
19133
Direction
E
STREET_NAME
LIBERTY
STREET_TYPE
RD
City
CLEMENTS
APN
00911011
ENTERED_DATE
9/24/1996 12:00:00 AM
SITE_LOCATION
19133 E LIBERTY
RECEIVED_DATE
9/23/1996 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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ADMIN
Supplemental fields
FilePath
\MIGRATIONS\L\LIBERTY\19133\CO0006953.PDF
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EHD - Public
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Urate'run : 17/13!9? SAN JOA-UUTN ti eport 95104 <br /> Run by, : CAROLD Page # 1 <br /> Copv, # : 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> v <br /> COMPLAINT # = COOO6953 Program/Element 4200 <br /> Taken by : 0644 NORGARD Date: 09/23/96 Assigned to : 0644 NORGARD Date: 09/23/96 <br /> Hard copy Printed: 09/24!96 <br /> Facility Name : Fac ID : <br /> BILL to inventoried FACILITY: <br /> Location: _19 1 _ _,-LIBERTY. ( l( X33 �L� P4" (Must have FACILITY IDA) <br /> Complainant : ANONYMOUS Home Phone: <br /> . ......... . .. . ... <br /> Address = Work Phone: <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name : Loc Code : <br /> ....._.. — ......... ........._...... <br /> Address: BOS Dist <br /> ..........- <br /> City: APN # <br /> Phone . <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name : Home Phone: <br /> Address : Work Phone : <br /> City : <br /> Nature of Complaint: <br /> SOLID WASTE BEING DUMPED ON THE PREMISE ADDRESS ( FIRST HOUSE WEST OF <br /> 19211 EAST LIBERTY ROAD ) PER TED NORGARD . <br /> e <br /> COMPLAINT Info — <br /> COMPLAINT MODE: A AGENCY REFERRAL <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: <br /> _........ <br /> Veld Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 07-Refer to Other Agency 08-Not Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by : Date: <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I II III IV for Investigation <br />
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