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F7 <br />N Complaint Investigation Form Report#: 5104 <br />COMPLAINT ID: C00047392 Site Location: 5420 PACIFIC AVE Account ID: AR0024926 <br />Received by: EE0003600 BLACKWELL Received Date: 9/10/2018 <br />Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date: 9/10/2018 <br />Program/Element Code:1600 - FOOD PROGRAM <br />Complainant: : <br /> <br /> <br /> <br /> <br /> <br />ure of complaint: <br />ON 09/09/18 AT AROUND 6PM, COMPLAINANT FOUND A BALL POINT PEN INA PASTA DISH (MAMA'S TRIO) TOOK A PICTURE AND SPOKE <br />TO THE SERVER AND THE MANAGER. LEFT AFTER SPEAKING TO THE MANAGER. COMPLAINANT REQUEST CALL BACK FORM THE <br />INSPECTOR. <br />Complaint Mode: P Complaint Mode Codes A -Agency Referral B-Bd of Supervisors / City Council C -Counter F -Fax <br />E -Code Enforcement M -Mail / Correspondence O -Other EH Unit P -Phone <br />I -Internet / Email S -Sheriffs Office <br />PROPERTY INFORMATION <br />Facility: FA0014657 - ROMANOS MACARONI GRILL <br />Site Location <br />5420 PACIFIC AVE <br />STOCKTON, CA 95207 <br />Cross Street <br />ROBINHOOD <br />Mailing Address: <br />1855 BLAKE ST STE 200 <br />DENVER, CO 80202--128 <br />Phone <br />:209-951-7064 EXT: <br />District 002 - MILLER, KATHERINE <br />APN 10224023 <br />Date Abated !� :/f _ J <br />Send Referral to <br />Referral Address <br />Complaint Status Code: D <br />Circle appropriate Status Code <br />01 - Field Response -Violations Cited and Corrected <br />02 - Office Response Only <br />06 - Violations Cited - see Linked PROGRAM FACILITY FILE <br />07 - Refferred to Other Agency <br />08 Unable to Verify Alleged Complaint <br />POSTED SUBSTANDARD/UNSECURED - See Housing File <br />11 - Multiple Complaints - SEE ACTIVE CASE # <br />12 - DA Referred Complaint -See Program Enforcement Action Form <br />15 -ACTIVE HOUSING CASE - NEW COMPLAINT see ACTIVE CASE # <br />28 - Alleged FBI - No Major Violations Identified <br />29 - Alleged FBI - Major Violations Identified <br />OWNER INFORMATION <br />Owner: OW0015906 -MAC ACQUISITION LLC <br />RP/DBA <br />RPAddress 6750 LB] FREEWAY <br />DALLAS, TX 75240 <br />Billing Address 3100 S GESSNER SUITE 125 <br />HOUSTON, TX 77063 <br />Home Phone : 866-997-4777 <br />Work Phone 632-649-2200 hX I: <br />Location Code 01- STOCKTON <br />Inspector ID #: F/Ohr5c. j a -�z_ <br />Referral Letter Sent by <br />Date: <br />50 - LEAD Assessment Performed -No Abatement Required <br />52 - LEAD Abatement Reqired-See Program Record File <br />97 - Disaster Planning and Response <br />99 - UNSPECIFIED -Old Complaint -No Original Found <br />MN - EHD Monitoring Status <br />PD - Permit Issued -Pending Well Installation <br />RS - Resolved - New Well Installed <br />S1 -Tank pumped <br />S2 - Hooked up to public sewer <br />S3 - Septic system repaired <br />omplaint Reviewedby:..,. q I ul m Date: I Updatedy: Date: <br />5104.rpt <br />