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Complaint Investigation Form Report* 5104 <br /> COMPLAINT ID: C00025263 Site Location: 39 W CHARTER WAY <br /> Account 1D: AR0004601 <br /> Received by: EE0003600 BLACKWELL <br /> Received Date: 1014!2006 Print Date: 10/4/2006 3:31:10PM <br /> Assigned To: EE0001699 YOAKUM Assigned Date: 10/4/2006 SCAMD <br /> ProoramlElement Code 1600-FOOD PROGRAM <br /> Complainant: :ARLENE Nome Phone <br /> Work Phone - <br /> Address <br /> Nature of complaint.- <br /> BAGS <br /> om laint.BAGS OF"WESTERN FAMILY'RICE HAS WORMS IN IT(C)WAS AT FACILITY ON 1012!06& 10104106. COMPLAINED TO CHECKER ON 10/04/06 <br /> &WAS TOLD TO GET ANOTHER BAG. (C)ALSO STATES THE MEAT SCALES DO NOT GET WIPED DOWN AND ARE COVERED WITH DRIED <br /> BLOOD,THE WHOLE STORE IS DIRTY. <br /> Complaint Mode: p Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter <br /> E_ _ <br /> Code Enforcement M_Mail/Correspondence O-Other EH Unit J_ P-Phone_ <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0002381-SUPERSAVE MARKET Owner: OW0001828-CHEN,WILLIAM;Z1 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 :209-464-8295 Work Phone :209464-7610 <br /> District 001 -GUTIERREZ,STEVE Location Code 01 -STOCKTON <br /> APN 14716038 <br /> Date Abated �p.5 -Ot'r Inspector. J 0ou&A.7 <br /> -------------------------------------------------- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code:0(_ <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 /> 06 EHD 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 f No Major Violations <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Major Violations Identified <br /> —P'duk <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 /> Complaint l iistory <br /> Attached But Not <br /> Scanned <br /> 5194.rpt <br />