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COMPLAINT ID: C00046700 <br />Receivedby: EE0000040 JIMENEZ <br />Assigned To: EE0000753 NG <br />Complaint Investigation Form <br />Site Location: 5354 PACIFIC AVE <br />Received Date: 12/16/1991 <br />Assigned Date: 5/24/2018 <br />Prowm/Element Code: 1600 - FOOD PROGRAM <br />Complainant: : <br /> <br /> <br />Na <br />Report #: 5104 <br />Account ID: : <br />Print Date: 5/24/2018 3:44:2111M <br />ure of complaint: <br />THIS COMPLAINT WAS FOUND IN FILING CABINET AND ALLEGES "20 CASES OF FOOD STORED IN RESTROOM -SEEN WHEN A CUSTOMER <br />JVENT TO USE THE BATHROOM." ORIGINAL CO # 912214 DATED 12/16/1991 (GIVING ITAN ENVISION COMPLAINT # TO HAVE IN <br />DATABASE FOR FUTURE REFERENCE.) <br />Complaint Mode: P Complaint Mode Codes A -Agency Referral <br />E -Code Enforcement <br />I -Internet / Email <br />PROPERTY INFORMATION <br />Property Name: <br />Site Location 5354 PACIFIC <br />STOCKTON, CA 95207 <br />Cross Street <br />Phone : <br />District 002 - MILLER, KATHERINE <br />APN NEAR 10224019 <br />Date Abated 9 - Df, -- <br />Send Referral to <br />Referral Address <br />Complaint Status Code: 11 <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 />B-Bd of Supervisors / City Council C -Counter F -Fax <br />M -Mail / Correspondence O -Other EH Unit P -Phone <br />S -Sheriffs Office <br />PROPERTY OWNER INFORMATION <br />Responsible Party or Property Owner: HICKORY FARMS <br />RP/DBA HICKORY FARMS <br />RPAddress 5354 PACIFIC AVE <br />STOCKTON, CA 95207 <br />Billing Address 5354 PACIFIC AVE <br />Home Phone <br />Work Phone <br />Location Code 01 - STOCKTON <br />Inspector ID #: j,\ � ) <br />Referral Letter Sent by <br />Date: <br />50 - LEAD Assessment Performed -No Abatement Required <br />52 - LEAD Abatement Regired-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 />omp amt Reviewed y: ate: pate y: ,' a `i <br />s "14.1/ /3 <br />5104.rp1 <br />