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` Complaint Investigation Form Report#: 5104 <br />COMPLAINT ID: C00046396 Site Location: 1616 E HAMMER LN <br />Received by: EE0000025 SEDRA <br />Assigned To: EE0000753 NG <br />Received Date: 11/15/1991 <br />Assigned Date: 4/19/2018 <br />Program/Element Code .1600 -FOOD PROGRAM <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />THIS COMPLAINT WAS FOUND IN FILE CABINET AND ALLEGES "BOUGHT LAST WEEK CAN OF CROWN PRINCE OYSTERS AND ATE ENTIRE <br />4MOUNT IN CAN ON 11/14/1991. BECAME ILL WITH STOMACH CRAMPS, HAD SWELLING IN THE THROAT AND HAD SHAKING SPELL." <br />DRIGINAL COMPLAINT NUMBER 91-2092 DATED 11/15/1991 (GIVING IT AN ENVISION COMPLAINT NUMBER TO HAVE IN DATABASE FOR <br />=UTURE REFERENCE). <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 PROPERTY OWNER INFORMATION <br />Property Name: COSTCO <br />Site Location 1616 E HAMMER <br />STOCKTON, CA 95210 <br />Cross Street WEST LANE FRONTAGE <br />Phone - <br />District 002 - MILLER, KATHERINE <br />APN 09428011 <br />Responsible Party or Property Owner <br />RP/DBA <br />RP Address <br />Billing Address <br />Home Phone <br />Work Phone <br />Location Code 01 - STOCKTON <br />Date Abated C� I —I _ I "k- Inspector ID #: /-,) Q <br />Send Referral to Referral Letter Sent by <br />Referral Address Date: <br />Complaint Status Code: 4� C <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 />10 - 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 />5104. rpt <br />50 - LEAD Assessment Performed -No Abatement Required <br />52 - LEAD Abatement Reqired-See Program Record File <br />97 - Disaster Planning and Response <br />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 />Updated by: ate: / <br />(, _ �t) 1 ✓ <br />