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d�. <br /> Complaint Investigation Form Report# 5104 <br /> COMPLAINT ID: 000047537 Site Location: 1230 W. KETTLEMAN LN Accountia AR0014570 <br /> Received by: EE0000707 VERNENGO Received Date: 10/2/2018 Print Date: 10/2/2018 2:05:33PM <br /> Assigned To: EE0001084 RAMIREZ Assigned Date: 10/2/2018 <br /> j Prog <br /> :ANONYMOUS Home Phone <br /> Address Work Phone <br /> Mail Address <br /> Nature of corn taint: <br /> COMPLAINANT STATED SHE REQUESTED A TO GO CONTAINER FOR THE REMAINDER OF BREAKFAST,THE CONTAINER HAD A LIVE <br /> COCKROACH IN IT. SHE ASKED TO SPEAK TO THE MANAGER,-SHE WAS TOLD MANAGER WAS NOT THERE. <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 /> '1 I-Internet/Email S-Sherifrs Office <br />;`•5- ------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------- <br /> '3 PROPERTY INFORMATION OWNER INFORMATION <br /> Facility:FA0003926-IHOP Owner: OW0006538-LAXMI US 1234 FOOD CORP <br /> Site Location 1230 W KETTLEMAN LN RP/DBA :IHOP <br /> LODI,CA 95240 RPAddress 2213 KELSO PEAK AVE 170 <br /> Cross Street HAM LN BAKERSFIELD,CA 93304 <br /> Mailing Address: 1230 KETTLEMAN LN Billing Address 1230 KETTLEMAN LN <br /> LODI,CA 95240 LODI,CA 95240 <br /> f yy. Home Phone <br /> Phone :209-369-1361 EXT: 0 Work Phone :209-369-1361 EXI: <br /> District 004-WINN,CHARLES Location Code 02-LODI <br /> APN 06004001 <br /> Date Abated /D —O 3 / Q Inspector ID#: <br /> L J `1 <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Y <br /> ,. Complaint Status Coder <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Corrected 50-LEAD Assessment Performed-No Abatement Required <br /> 02-Office Response Only 52-LEAD Abatement Regired-See Program Record File <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> 07-Refferred to Other Agency 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08- nable to Verify Alleged Complaint MN-EHD Monitoring Status <br /> � 10-POSTED SUBSTANDARD/UNSECURED-See Housing File PD-Permit Issued-Pending Well Installation <br /> 11-Multiple Complaints-SEE ACTIVE CASE# RS-Resolved-New Well Installed <br /> " 12-DA Referred Complaint-See Program Enforcement Action Form S1-Tank pumped <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S2-Hooked up to public sewer <br /> 28-Alleged FBI-No Major Violations Identified S3-Septic system repaired <br /> 29-Alleged FBI-Major Violations Identified <br /> '•si <br /> omplaint Reviewedy:__. (i3 Date: p a e y: Date: <br /> 5104.rpt 7 <br />