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Complaint Investigation Form Report#:5104 <br /> r <br /> COMPLAINT ID: C00026707 Site Location: 3201 W BENJAMIN HOLT DR STE 1P AccountlD: AR0005124 <br /> Received by: EE0003600 BLACKWELL Received Date: 7/23/2007 Print Date: 7/23/2007 2:49:09PM <br /> Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date: 7/23/2007 <br /> Program/Element Code:1600-FOOD PROGRAM { <br /> Complainant. :SIERRA Nome Phone 209-629-2746 SC/{ <br /> Address Work Phone ; a1 <br /> NED <br /> Nature of complaint <br /> AT NOON ON 7122107,(C)ORDERED A FOOT LONG TURKEY SANDWICH WITH LETTUCE,TOMATOES, PICKLES,WAX PEPPERS,SALT, <br /> PEPPER,OIL,AND VINEGAR TO GO. (C)ATE HALF OF SANDWICH FOR LUNCH,AND THE OTHER HALF FOR DINNER. ON 7123107 AT 6 AM, <br /> (C)BECAME ILL WITH DIARRHEA AND VOMITING,WHICH AT TIME OF COMPLAINT SHE STILL HAD. NO DOCTOR WAS CONTACTED; <br /> HOWEVER(C)CALLED FACILITY ON 7123107 TO COMPLAIN. WHILE(C)WAS IN FACILITY ON 7/22/07,SHE OBSERVED A FLY REPEATEDLY <br /> LAND ON HER BREAD AND REQUESTED NEW BREAD. (C)OBSERVED EMPLOYEE PUT THE BREAD FLY LANDED ON BACK ON OVEN SHELF <br /> INSTEAD OF IN THE GARBAGE. "*(C)REQUESTS A CALL BACK FROM INSPECTOR.— <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors i City Council C-Counter <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0001790-SUBWAY SANDWICHES Owner: OW0014445-KAHLON,JAGWINDER K <br /> Site Location 3201 W BENJAMIN HOLT DR STE 18 RP/DBA SUBWAY <br /> STOCKTON,CA 95219 RP Address 1840 CHATFIELD CIR <br /> STOCKTON,CA 95209 <br /> Mailing Address: 3201 W BENJAMIN HOLT DR STE 18 Billing Address 1840 CHATFIELD CIR <br /> STOCKTON,CA 95219 STOCKTON,CA 95209 <br /> Home Phone :209-955-1842 <br /> Phone :209-952-8873 Work Phone :209-952-8873 <br /> District 002-RUHSTALLER,LARRY Location Code 01 -STOCKTON <br /> APN 10017009 <br /> Date Abated —'-ry_2 Inspector: `� — <br /> Send Referral to L Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 14-ENFORCEMENT CASE-Transferred to ER FILE <br /> 02-OFFICE ABATED 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 03-NAI SENT 16-LETTER SENT TO TENANT <br /> 04-NOTICE TO ABATE ISSUED 17-15 DAY LETTER SENT <br /> 05-ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> 06-EHD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCYENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> 08-UNABLE TO VERIFY 28- ODBORNE ILLNESS-Unconfirmed l No Major Violations <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 30-15 Day Letter Sent-Confirmed Complaint Complaint History <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 31-15 Day Letter Sent-Alleged Complaint Attached But Not <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 50-LEAD HAZ EVALUATION REQUIRED(1) Scanned <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> eA <br /> cats <br /> 5104,rpt <br />