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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00016842 Site Location: 2708 COUNTRY CLUB BLVD Account/D: ARD020836 <br /> Received by: EE0000099 Frost Received Date: 11/20/2001 <br /> Assigned To: EE0001084 RAMIREZ Assigned Date: 11/20/01 <br /> ProararrVElement Code 1624-RESTAURANT/BAR 21-50 SEATS <br /> Complainant., CATHARINE RIGGS Home Phone: <br /> Address: Work Phone: 209-933-9107 <br /> Nature of complaint: <br /> 11:40 LAST WEEK, FLOOR DIRTY,TABLE NOT CLEAN(STICKY)ATE CHILI RELLENO,DID NOT TASTE RIGHT, IT MADE COMPLAINANT <br /> SICK. <br /> Complaint Mode P Complaint Mode Codes: A-Agency Referral B-Bd of Supervisors/City Council E-Code Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0012606-LOS ADOBES TAQUERIA Owner: OW0009804-PADILLA,MARTIN <br /> RP/DBA: LOS ADOBES TAQUERIA <br /> Site Location: 2708 COUNTRY CLUB BLVD <br /> STOCKTON,CA 95204 RP Address: 182 CASTLEWOOD AVE <br /> LATHROP,CA 95330 <br /> Mailing Address: 2708 COUNTRY CLUB BLVD <br /> STOCKTON,CA 95204 Billing Address:: 182 CASTLEWOOD AVE <br /> LATHROP,CA 95330 <br /> Phone: Phone: Him: 209467-7203 <br /> Wk: 209467-7203 <br /> District 001 -GUTIERREZ,STEVE Location Code 99-UNINCORPORATED AREA <br /> DPN completed <br /> Date Abated <br /> Inspector <br /> Send Referral FILE CON <br /> Referralai Address: <br /> Address: <br /> Referral Letter Sent : <br /> Date: <br /> Complaint Status Code: <br /> 01-Field Abated 10-Substandard Property-See HOUSING ABATEMENT File <br /> 02-Office Abated - 15-Active Housing Case-New Complaint See Active Case It <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 50-Lead Hazard Evaluation Required(1) <br /> 06-EHD Permit Facility-See Linked Premise File 52-Lead Huard Abatement in Progress(3) <br /> 07-Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) <br /> 08-Invalid/Unable To Verify 51-Lead Hazard Work Plan Submitted(2) <br /> 09-Foodbome Illness 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> 11-Multiple Complaints-See Active Case tl 55-Lead Hazard Monitoring Schedule(6) <br /> 12-Enforcement Case-Transferred To LIQUID WASTE File 56-Lead Hazard Abatement Complete(7) <br /> 13-Enforcement Case-Transferred To SOLID WASTE File 57-Lead Hazard Property Vacant W/Soil Contamination <br /> 14-Enforcement Case-Transferred To ER File 58-Lead Hazard Case-See Active File For This Site <br /> 0104.rml <br />