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Complaint Investigation Form Report#:5104 <br /> C6 PLAINT ID: C00020797 Site Location: 39 W CHARTER WAY Account ID: AR0004601 <br /> Receivedby: EE0006519 RISA Received Date: 5/13/2004 Print Date: 5/13/2004 1:19:30PM <br /> Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date: 5/13/2004 <br /> Program/Element Code 1600-FOOD PROGRAM <br /> Complainant: :SHELLIA ANDERSON Home Phone i 209-469-7273 r <br /> Address Work Phone <br /> !Nature of Com taint. <br /> PORK CHOPS"FROM THIS FACILITY MAKE HER SICK,SHE AND OTHERS HAVE BOUGHT MEAT AND FISH AT OTHER TIMES AND BECAME <br /> ILL.STORE WILL NOT GIVE MONEY BACK. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors t City Council C-Counter <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0002381-SUPERSAVE MARKET Owner: OW0001928-CHEN,WILLIAM;ZI MING WU ETC <br /> Site Location 39 W CHARTER WAY RP/DBA SUPERSAVE MARKET <br /> STOCKTON,CA 95206 RP Address 39 W CHARTER WAY <br /> STOCKTON,CA 95206 <br /> Mailing Address: 39 W CHARTER WAY Billing Address 39 W CHARTER WAY <br /> STOCKTON,CA 95206 STOCKTON,CA 95206 <br /> Home Phone ;209-464-7610 <br /> Phone :209464-9295 Work Phone :209-464-7610 <br /> District : Location Code 01 -STOCKTON <br /> APN 147M038 <br /> f <br /> Date Abated ~-! Inspector J/14,2 <br /> Y—— —— —— <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> L7v <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 If <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 /> 06-EHD PERMIT FACILITY-see Linked PROGRAM FACL;TY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCY 28-FOODBORNE ILLNESS-Unconfirmed <br /> 08-UNABLE TO VERIFY 29-FOODBORNE ILLNESS-Confirmed Complaint History <br /> 09-FOODBORNE ILLNESS 50-LEAD HAZ EVALUATION REQUIRED(1) Attached But Not <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 51 -LEAD HAZ WORK PLAN SUBMITTED(2) Scanned <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 12-ENFORCEMENT'CASE-Transferred to LIQUID WASTE RLE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 54-LEAD HAZ DUST EVALUATION SATISFACTORY(5) <br /> 5104.fpt <br />