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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00023667 Site Location: 520 CAROLYN WESTON BLVD STE AccountlD: AR0023586 <br /> Received by: EE0009058 LOWE Received Date: 11/15/2005 Print Date:l ill 512005 11:38:51AM <br /> Assigned To: EE0001699 YOAKUM Assigned Date: 11/15/2005 <br /> P ra l men Code:1600-FOOD PROGRAM <br /> Complainant: :STOCKTON FIRE-CANDY Home Phone <br /> Address Work Phone <br /> Nature of complaint <br /> FIRE IN FACILITY. (DEEP FRYER) <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> -------------------------- --------- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0013954-JALAPENO'S TAQUERIA Owner: OW0011041-CERVANTES,REYES <br /> Site Location 520 CAROLYN WESTON BLVD STE A RP/DBA : <br /> STOCKTON,CA 95206 RP Address 2735 NEMAHA WAY <br /> STOCKTON,CA 95206 <br /> Mailing Address: 520 CAROLYN WESTON BLVD STE#A Billing Address 2735 NEMAHA WAY <br /> STOCKTON,CA 95206 STOCKTON,CA 95206 <br /> Home Phone :209-942-4147 <br /> Phone :209-234-2585 Work Phone :209-234-2585 /� <br /> Distract 001 -GUTIERREZ,STEVE Location Code 01-STOCKTON SCANNED <br /> APN 16422011 <br /> Date Abated // 2&6q— Inspector. J rd�KLf ly <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: Complaint History <br /> Attached But Not <br /> Scanned <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 /> QyD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCY 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> 08-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Confirmed <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 5104.rpt <br />