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Complaint Investigation Form Report 5104 <br /> COMPLAINT ID: C00015160 Site Location: 15135 W EIGHT MILE RD Account ID: AR0001624 <br /> Recelvedby: EE0000794 MATHEW Received Date: 11/7/2000 <br /> Assigned To: EE0002685 BOOTH Assigned Date: 11/9/00 <br /> Prooram/Element Code: 1624-RESTAURANT/BAR 21-50 SEATS <br /> <br /> <br /> Nature of complaint: <br /> COOK FIRED FROM FACILITY HAD HEPATITIS,PLEASE INVESTIGATE TO CONFIRM IF COOK HAD HEPATITIS A. <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: FA0006877-HERMAN&HELENS CAFE Owner: OW0005642-HERMAN&HELENS MARINA INC <br /> RP/DBA: HERMAN&HELENS CAFE <br /> Site Location: 15135 W EIGHT MILE RD <br /> STOCKTON,CA 95207 RP Address: VENICE ISLAND FERRY <br /> STOCKTON,CA 95219 <br /> Mailing Address: VENICE ISLAND FERRY <br /> STOCKTON,CA 95219 Billing Address:: VENICE ISLAND FERRY <br /> STOCKTON,CA 95219 <br /> Phone: 1st: 209-951-4691 Phone: Hm: 209-957-5250 <br /> Wk: Number Not Specified <br /> District 004-SEIGLOCK,JACK Location Code 99-UNINCORPORATED AREA <br /> APN <br /> Date Abated Il —t5 -Ln <br /> Inspector lie — <br /> Send Referral to: <br /> Referral Address: <br /> Referral Letter Sent by., <br /> Date: C7/� <br /> Complaint Status Code: O " <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 /> 06-EHD Permit Facility-See Linked Premise File 52-Lead Hazard Abatement in Progress(3) <br /> ,RBl7'��Referred To Other Agency 53- Lead Hazard Visual Inspect Satisfactory (4) <br /> I�0$/Invalid/Unable To Verify 51 - Lead Hazard Work Plan Submitted(2) <br /> 9-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 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.na <br />