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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00034503 Site Location: 5420 FRED RUSSO AccountlD. <br /> Receivedby: EE0001084 RAMIREZ Received Deter 1/9/2012 Print Date: 1/10/2012 8:29:54AM <br /> Assigned To: EE0001084 RAMIREZ Assigned Date: 1/9/2012 <br /> Program/Element Code:1600-FOOD PROGRAM <br /> Complainant: :THOMAS CARR Home Phone <br /> Address :ONE STOP BEYOND ICE CREAM Work Phone - <br /> E-Mail Address <br /> Nature of complaint., <br /> 1 ILLEGAL VENDOR SELLING COTTON CANDY 1:30-1:45 PM. <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-Intemel/Email S-Shenffs Office <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner <br /> Site Location 5420 FRED RUSSO RP/DBA <br /> STOCKTON,CA RP Address <br /> Cross Street <br /> Billing Address <br /> Home Phone <br /> Phone Work Phone <br /> District 001 -VILLAPUDUA Location Code 99-UNINCORPORATED AREA <br /> APN <br /> Date Abated �>�1� Inspector ID#: ( / <br /> Send Referral to Referral Letter Sent by <br /> Relerral Address Date: <br /> Complaint Status Code: W <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 02-OFFICE ABATED 50-LEAD Assessment Performed-No Abatement Required <br /> 03-NAI SENT 52-LEAD Abatement RegiredSee Program Record File <br /> 04-NOTICE TO ABATE ISSUED 97-Disaster Planning and Response <br /> 05-DA-ENFORCEMENT ACTION INITIATED 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08-EHD FACILITY-see Linked PROGRAM FACILITY FILE CL-Case Closed <br /> r07%REFERRED TO OTHER AGENCY <br /> t\`01'88-- NABLE TO VERIFY <br /> POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 5104 rpt <br />