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Complaint Investigation Form <br /> Report#:5104 <br /> COMPLAINT ID: C00043721 Site Location: 1360 E.ALPINE AVE Account ID: AR0009525 <br /> Recahledby.: EE0000035 HERNANDEZ Received Date: 6/29/2017 <br /> Assigned 7oEE0009488 WONG: Pdnt Date: 6/29/2017 9:07;06AM <br /> Assigned Date: 6/29/2017 <br /> Pmaram/Piement Code.1600-FOOD PROGRAM <br /> Complainant: :NANCY DACUMOS Home Phone <br /> Address : 209-915-5759 <br /> Work Phone <br /> -Mail Address <br /> Nature of co m lain t: <br /> COMPLAINANT WENT TO FOOD CART 430PM ON 6/27/17.COMPLAINANT BOUGHT ONE POUND OF TRI TIP AND THOUGHT THE MEAT WAS <br /> TOUGH BUT STILL ATE IT.GOT SICK WITH VOMITAND DIARRHEAAROUND 530PM.WOULD LIKE CALL BACK FROM INSPECTOR. <br /> Complaint Mode: pA-Agency Referral B-Bd of Su rvisors/Ci Council <br /> Pe tY C-Counter F-Fax <br /> Complaint Mptle Codes <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> 1-Internet/Email S-Sheriffs Office <br /> PROPE TY INFORMATION -------------- <br /> �— OWNER INFORWTION <br /> Facility;FAOO - GR TENSE,46t7TAY655 / u ei , Owner: OW0001280-GUERRERO,ALICIA <br /> its Location 1360 E ALPINE AVE c V RP/DBA <br /> STOCKTON,CA 95204--350 ,c <br /> �T JC 8 RPAtltlress 9177 BARBARESCO CIR <br /> Crass Street STOCKTON,CA 95212 <br /> Mailing Address: 1360 EALPINE AVE -7 Billing Address 9177 BARBARESCO CIR <br /> STOCKTON,CA 95204--350 ✓ STOCKTON,CA 95212 <br /> 2 -717 /I Home Phone 209-462-3425 <br /> Phone ;209-062-3425 (�J Work Phone :209-242-3358 <br /> Disinct 001-VILLAPUDUA,CARLOS Location Code <br /> APN 11708005 <br /> ———Date Abated —— Inspector ID#: <br /> -- <br /> re —————————————— <br /> Referral Ad <br /> SendReferral <br /> Adreidress s Referral Letter SI <br /> y <br /> Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> CTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 01-Field Response-Violations Cited and Corrected 28'- eged FBI-No Major Violations Identified <br /> 02-Office Response Only 29-Alleged FBI-Major Violations Identified <br /> 50-LEAD Assessment Performed-No Abatement Required <br /> 52-LEAD Abatement Reqired-See Program Record File <br /> 97-Disaster Planning and Response <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-Refferred to Other Agency <br /> 08-Unable t0 Verity Alleged Complaint MN-EHD Monitoring Status <br /> PD-Permit Issued-Pending Well Installation <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File RS-Resolved-New Well Installed <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Program Enforcement Action Form <br /> ompalnt eviewe y: ale: <br /> / i iipdaied oy.1 / w v V, a, <br /> 5104.rpt 1. �l <br />