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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: 000042083 Site Location: 2808 COUNTRY CLUB BLVD Account ID.' AR0041583 <br /> Receivedby: EE0000007 MORELLI Received Date 8/19/2016 PrintDate: 8/19/201611.31:34AM <br /> Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date.: 8/19/2016 <br /> Pmoram/Element Code:1600-FOOD PROGRAM <br /> Complainant: :JENNIFER CURRY Home Phone 209-430-1864 <br /> Address Work Phone <br /> -Mail Atltlress <br /> Nature ofcomplaint: <br /> COMPLAINANT ALLEGES THAT THE DELI CHEESE TRAY EXPIRED,DISHES ARE NOT BEING RINSED OR SANITIZED,DIRTY AND UN-KEPT <br /> FOOD PREP AREA,MEATS ARE BEING USED PAST EXPIRATION DATE. PLEASE CALL COMPLAINANT WITH FINDINGS. <br /> Complaint Mode: P 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 /> 1-Intemet/Email S-Sheriff's Office <br /> -------------------------------------------------- <br /> PROPERTY INFORMATION OWNER INFORMATION <br /> Facility:FA0022709-SAFEWAY STORE#1769 Owner: OW0000429-SAFEWAY INC <br /> Site Location 2808 COUNTRY CLUB BLVD RP/DBA <br /> STOCKTON,CA 95204 RP Address 5918 STONERIDGE MALL RD <br /> Cross Street PLEASANTON,CA 94588 <br /> Mailing Address.* PO BOX 29096 MS 6516 Billing Address PO BOX 29096 MS 6516 <br /> PHOENIX,AZ 85038 PHOENIX,AR 85038-9096 <br /> Home Phone :925-467-3000 <br /> Phone :209.461-5555 Work Phone <br /> District 001-VO,LAPUDUA,CARLOS Location Code <br /> APN <br /> Date Abated c�_Z)� f_ Inspector ID#: C) 1 _Z'J�+-z'Send Referral to T' u, Referral Letter Sent by <br /> Relerra/Address Date: <br /> Complaint Status Code: V V <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 01-Field Response-Violations Cited and Corrected 28-Alleged FBI-No Major Violations Identified <br /> 02-Office Response Only 29-Alleged FBI-Major Violations Identified <br /> 50-LEAD Assessment Performed-No Abatement Required <br /> 52-LEAD Abatement Reqired-See Program Record File <br /> 97-Disaster Planning and Response <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-Refferred to Other Agency <br /> nUnable to Verity Alleged Complaint MN-EHD Monitoring Status <br /> PD-Permit Issued-Pending Well Installation <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File RS-Resolved-New Well Installed <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> ompaint Reviewed by: ate: pdate y. ateyi/,1/, <br /> 510,rpt <br />