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Complaint Investigation Form I Report 5104 <br /> COMPLAINT ID: C00015963 Site Location: 3201 W BENJAMIN HOLT DR `I Account ID: AR0005124 <br /> Received by: EE0009058 Lowe Received Date: 5/21/2001 <br /> Assigned 7o: EE0000467 CARRUESCO Assigned Date: 5121101 I <br /> Prodrarnl lement Code: 1624-RESTAURANTIBAR 21-50 SEATS �I <br /> Complainant: <br /> i <br /> Nature of complaint: I` <br /> ATE CHICKEN CEASAR WRAP 05-18-01.05-19-01 BECAME ILL WITH VOMITING. <br /> Complaint Mode P Complaint Mode Codes: A-Agency Referral B-Bd of SupervisorslCity Council E-Code Enforcement <br /> M-MaillCorrespondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0001790-SUBWAY SANDWICHES Owner: OW0003612-TIWANA,AMRITPAL I�. <br /> r <br /> RP/DBA: SUBWAY SANDWICHES&SALADS <br /> Site Location: 3201 W BENJAMIN HOLT DR <br /> STOCKTON,CA 95219 RP Address: 612 DOVEWOOD ST <br /> STOCKTON, CA 95210 <br /> Mailing Address: 612 DOVEWOOD ST F <br /> Billing Address:: 612 DOVEWOOD STi <br /> STOCKTON,CA 95210 <br /> STOCKTON, CA 95210 <br /> Phone:1st: 209-952-8873 Phone: Hm: 209-951-9861 .� <br /> Wk: 209-467-7101 <br /> A. <br /> District 002-MARENCO, DARIO Location Code 01 -STOCKTON <br /> APN <br /> Date Abated lD a f <br /> Inspector <br /> 3 <br /> F <br /> Send Referral to: <br /> Referral Address: <br /> I <br /> i <br /> Referral Letter Sent by: <br /> Date: <br /> Y <br /> Complaint Status Code: <br /> u <br /> 01 -Field Abated 10-Substandard Property-See HOUSING ABATEMENT File <br /> 02-Office Abated 15-Active Housing Case-New Complaint See Active Case# <br /> 03-NAI Sent 16-Letter Sent To Tenant I. <br /> 04-Notice To Abate Issued 17-15-Day Letter Sent <br /> 05-Enforcement Action Initialed 50-Lead Hazard Evaluation Required(1) <br /> 06-EHD Permit Facility-See Linked Premise File 52-Lead Hazard Abatement in Progress(3) <br /> Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) <br /> 08 Invalid/Unable To Verify 51 -Lead Hazard Work Plan Submitted(2) ' <br /> l <br /> Foodborne Illness 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> 11-Multiple Complaints-See Active Case# 55-Lead Hazard Monitoring Schedule(6) <br /> 12-Enforcement Case-Transferred To LIQUID WASTE File 56-Lead Hazard Abatement Complete(7) .i <br /> 13-Enforcement Case-Transferred To SOLID WASTE File 57-Lead Hazard Property Vacant WlSoil Contamination <br /> 14-Enforcement Case-Transferred To ER File 58-Lead Hazard Case-See Active File For This Site <br /> I � <br /> i <br /> 0164.rpt <br /> Q I' <br /> ' I� <br />