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v <br /> GC/✓L Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00046821 Site Location: 620 N CENTRALAVE AccountlD: <br /> Receivedby: EE0000040 JIMENEZ Received Date: 6/4/2018 Print Date: 6/4/2018 4:53:17PM <br /> Assigned To: EE0004589 LINHARES Assigned Date: 6/4/2018 <br /> 12=2m/Element ode:1600-FOOD PROGRAM <br /> Complainant: Complainant Not Specified Home Phone <br /> Address : Work Phone <br /> -Ma#Address lugghedlU@gmaii.com <br /> Nature of complaint: <br /> TRINA'S TEA KETTLE AND BOUTIQUE ON CENTRALAVENUE IN TRACY IS SERVING FOOD WITHOUT THE PROPER PERMITS. <br /> Complaint Mode: I 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-Shenfrs Office <br /> ----- <br /> OPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: <br /> Responsible Party or Property Owner <br /> Site Locatio7 620 N CENTRAL Rp/pgq <br /> TRACY,CA 95376 RPAddress <br /> Cross Street <br /> Billing Address <br /> Home Phone <br /> Phone <br /> Work Phone <br /> District 005-ELLIOTT,BOB Location Code 03-TRACY <br /> APN NEAR 23506909 <br /> Date Abated b- b-1 Inspector ID#: <br /> ------------------------------------------------------------------- -- <br /> - - ------------------------------------------------------------------------- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address <br /> Date: <br /> Complaint Status Code:O I <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Corrected 50-LEAD Assessment Performed-No Abatement Required <br /> 02-Office Response Only 52-LEAD Abatement Regired-See Program Record File <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> 07-ReRerred to Other Agency 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08-Unable to Verify Alleged Complaint MN-EHD Monitoring Status <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File PD-Permit Issued-Pending Well Installation <br /> 11-Multiple Complaints-SEE ACTIVE CASE# RS-Resolved-New Well Installed <br /> 12-DA Referred Complaint-See Program Enforcement Action Form S1-Tank pumped <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S2-Hooked up to public sewer <br /> 28-Allegetl FBI-No Major Violations Identified S3-Septic system repaired <br /> 29-Alleged FBI-Major Violations Identified <br /> omp ain ewewe y: <br /> Date fie J <br /> 5704.rpt <br />