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.--- <br /> Report#:5104 <br /> r Complaint Investigation Form <br /> COMPLAINT ID: COOOIN09 Site Location, 25520 E HWY 4 Account ID:AR0000066 <br /> Received by: EE0002685 BOOTH Received Date: 4/7/2000 <br /> Assigned To: EE0002685 BOOTH Assigned Date: 417/00 <br /> Program/Element Code: 1100-SMOKING ENFORCEMENT PROGRAM <br /> Complainant: <br /> <br /> Nature of complaint: <br /> SMOKING IN FACILITY WHERE FOOD IS PREPARED <br /> Complaint Mode Complaint Mode Codes A-Agency Referr, B-Bd of Supervisors/C14 C-Count( E-Code Enforceme <br /> M-Mail/Correspond4 O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0000067-FARMINGTON GENERAL STORE OW0000056-LADIGES,ROBERT C/ANTOINETTE K <br /> Site Location: 25520 E HWY 4 DBA: FARMINGTON GENERAL STORE <br /> FARMINGTON,CA 95230 RP Address: <br /> <br /> <br /> <br /> <br /> <br /> Wk: <br /> District: 003-SIMAS,EDWARD Location Code: 99-UNINCORPORATED AREA <br /> APN: <br /> Date Abated. <br /> Inspector. <br /> Send Referral to: <br /> Referral tetter Sent by.- <br /> Referral <br /> y.Referral Address: 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# <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 /> EHD Permit Facility-See Linked Premise File 52-Lead Hazard Abatement in Progress(3) <br /> Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) <br /> -Invalid/Unable To Verify 51-Lead Hazard Work Plan Submitted(2) <br /> 09-Foodborne Illness 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> 11-Multiple Complaints-See Active Case# 55-Lead Hazard Monitoring Schedule (6) <br /> 12-Enforcement Case-Transferred To LIQUID WASTE Fie 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.rpt <br />