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Complaint Investigation Form <br /> Report*5104 <br /> { COMPLAINT ID: C00033994 Site Location. 6800 WEST LN Account ID. <br /> Received by: EE0005944 ESCOTTO Received Date: 8/23/2011 Print Date: 8/23/2011 9:35:48AM <br /> Assigned To: EE0005944 ESCOTTO Assigned Date: 8/23/2011 <br /> P ram/Element Code:4200-LIQUID WASTE PROGRAM <br /> Complainant: :ANONYMOUS Nome Phone <br /> Address : Work Phone <br /> E-Mail Address <br /> Nature of complaint. <br /> SURFACING SEWAGE EMANATING FROM SEPTIC TANK. <br /> Complaint Mode: <br /> P P Complaint Mode Codes A-Agency Referral 8-Bd of Supervisors!City Council C-Counter F•Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Ocher EH Unit P-Phone <br /> _------------------- ----------------------------- <br /> —I-Internet!Email S-Sheriffs Office <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner:MARY SONGER/KASE MIKALIA <br /> Site Location 6800 WEST RP/DBA U-STORE IT <br /> STOCKTON,CA 95210 RPAddress 6800 WEST LN <br /> Cross Street BRIDLE STOCKTON,CA 95210 <br /> Billing Address 6800 WEST LN <br /> Nome Phone :209-951-0960 <br /> Phone Work Phone <br /> District 002-RUHSTALLER,LARRY Location Code 01 -STOCKTON <br /> APN 09406051 <br /> Date Abated !r� Inspector ID <br /> ---------------------------------------- <br /> Send.Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> r <br /> Complaint Status Code:�L <br />€ Circle appropriate Status Code <br /> 01-FIELD ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 02-OFFICE ABATED 50-LEAD Assessment Performed-No Abatement Required <br /> k 03-NAI SENT 52-LEAD Abatement Regired-See Program Record File <br /> 04-NOTICE TO ABATE ISSUED 97-Disaster Planning and Response <br /> 05-DA-ENFORCEMENT ACTION INITIATED 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE CL-Case Closed <br /> t <br /> 07-REFERRED TO OTHER AGENCY <br /> 08-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 /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 28.FOODBORNE ILLNESS-No Major Violations Identified <br /> 5104,rpt <br />