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Complaint Investigation Form Re 104 <br /> COMPLAINT ID: 000016580 Site Location: 525 W ACACIA ST Account ID:ARO 533 C <br /> Received by: EE0009058 Lowe Received Date: 9/26/2001 <br /> Assigned To: EE0001084 RAMIREZ Assigned Date: 9/26/01 �/'� n /V <br /> Prooram/Element Code, 4000-VECTOR CONTROL PROGRAM �0�,�,��� <br /> Complainant: <br /> <br /> Nature of complaint: <br /> (C)STATES IST FLOOR ER ROOM HAD ROACHES. (C)WENT TO BATHROOM AND SAW ROACHES IN THIS ROOM AS WELL. <br /> Complaint Mode P Complaint Mode Codes: A-Agency Referral B-Bd of Supervisors/City Council E-Code Enforcement <br /> M-Mail/Correspondence O-Other EH Unit GCounter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0002864-DAMERON HOSPITAL Owner: OW0002138-DAMERON HOSPITAL <br /> RP/DBA: DAMERON HOSPITAL <br /> Site Location: 525 W ACACIA ST RP Address: 525 W ACACIA <br /> STOCKTON,CA 95203 STOCKTON,CA 95203 <br /> Mailing Address: 525 W ACACIA <br /> STOCKTON,CA 95203 ST Billing Address:: W ACACIA <br /> STOCKTON,CA 95203 <br /> Phone:1st: 209-944-5550 Phone: <br /> Wk: 209-944-5550 <br /> District 001-GUTIERREZ,STEVE Location Code 01 -STOCKI-ON <br /> APN 137-153-04 <br /> Date Abated 10(al 0 <br /> Inspector �� <br /> Send Referral to: <br /> Referral Address: <br /> Referral Letter Sent by: <br /> Date: <br /> Complaint Status Code: 0-47, <br /> 21-Field Abated 10-Substandard Property-See HOUSING ABATEMENT File <br /> 02- ffice Abated 15-Active Housing Case-New Complaint See Active Case# <br /> NAI Sent 16-Letter Sent To Tenant <br /> D4-Notice To Abate Issued 17-15-Day Letter Sent <br /> 05-Enforcement Action Initiated 50-Lead Hazard Evaluation Required(1) <br /> D6-EHO Permit Facility-See Linked Premise File 52-Lead Hazard Abatement in Progress(3) <br /> 07-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 /> 09-Foodbome 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) <br /> 13-Enforcement Case-Transferred To SOLID WASTE File 57-Lead Hazard Property Vacant W/Soil Contamination <br /> 14-Enforcement Case-Transferred To ER File 58-Lead Hazard Case-See Active File For This Site <br /> o1al.rpt <br />