Laserfiche WebLink
Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00037665 Site Location: 3201 W BENJAMIN HOLT STE 99 Account/D. AR0010313 <br /> Receivedby: EE0009058 LOWE Received Date: 3/5/2014 Print Date. 3%x/201 3 2 36 2711M <br /> Assigned To: EE0006213 PEDRAZA Assigned Date: 3/5/2014 <br /> Program/Element Code:1600-FOOD PROGRAM <br /> Complainant. :BECKY Home Phone <br /> Address Work Phone <br /> -Mail Address <br /> Nature of complaint: <br /> ON 03/05/2014 @ 12:15(C)ORDERED SWEET AND SOUR PORK TO GO FOR LUNCH. 3/4 OF THE WAY THROUGH SHE FOUND A FULL <br /> SIMMERED COCK ROACH. <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-Sheriff's Office <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0007126-WONGS DELI Owner: OW0005855-WONG,CHUN FON <br /> Site Location 3201 W BENJAMIN HOLT DR 99 RP/DBA WONG'S DELI <br /> STOCKTON,CA 95219 RP Address 5427 BAROOK HOLLOW CT <br /> Cross Street BENJAMIN HOLT STOCKTON,CA 95219-2440 <br /> Mailing Address: 3201 W BENJAMIN HOLT STE 99 Billing Address 5427 BROOK HOLLOW CT <br /> STOCKTON,CA 95219 STOCKTON,CA 95219-2440 <br /> Home Phone :209-478-8154 <br /> Phone :209-952-6886 Work Phone :209-952-6886 <br /> District Location Code <br /> APN <br /> Date Abated 3 1( A Inspector ID#: <br /> -- ————————— ————— —— �"v <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date. <br /> oderCComplaint Status Code.- <br /> Circle <br /> ircle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE # <br /> 01-FELD ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> u nFFICE ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 03-.LAI SENT 50-LEAD Assessment Performed-No Abatement Required <br /> 04-NOTICE TO ABATE ISSUED 52-LEAD Abatement Reqired-See Program Record File <br /> 05-DA-ENFORCEMENT ACTION INITIATED 97-Disaster Planning and Response <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-REFERRED TO OTHER AGENCY CL-Case Closed <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11-Multiple Complaints -SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 5104 rpt <br />