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1 <br /> Complaint Investigation Form R <br /> eport#:5104 1 <br /> COMPLAINT ID: C00022041 Site Location: 1347 S EL DORADO ST Account ID: AR0007910 <br /> Received by. EE0006519 DISA Received Date: 113!2005 Print Date: 1/4/2005 2:30:35PM <br /> Assigned To: EE0001699 YOAKUM Assigned Date: 1/4/2005 <br /> Proaram/Element Code 1600-FOOD PROGRAM <br /> Complainant: :ANITA RAZO Home Phone <br /> Address Work Phone :916-327-5315 <br /> Nature of complaint. <br /> MRS.RAZO AND HUSBAND STOPPED FOR DINNER.WHILE EATING SAW A COCKROACH WALK ACROSS TABLE OVER THERE FOOD AND <br /> THEN DOWN THE TABLE WHERE THERE WERE MORE COCKROACH'S.WAITRESSES DID NOT SEEM SURPRISED.PLEASE SEE COMPLAINT <br /> LETTER.THE FOOD WAS GOOD,BUT NEEDLESSTO SAY SEEING ALL THOSE ROACHES MADE BOTH ME AND MY HUSBAND ILL AND SICK TO <br /> OU-ZSTOMACHS. <br /> Complaint Mode: I ComplaintMode Codes A-Agency Referral B-Bd of Supervisors I City Council C-Counter <br /> :1 E-Code Enforcement M-Mail I Correspondence O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0006409-EL GRULLENSE(TAQUERIA) Owner: OW0001107-GUERRERO,RAMON&MIQUEL <br /> Site Location 1347 S EL DORADO ST RP/DBA : <br /> STOCKTON,CA 95206 RPAddress 1327 S WILSON WY <br /> STOCKTON,CA 95205 <br /> Mailing Address: 1331 S WILSON WAY Billing Address 1327 S WILSON WY <br /> STOCKTON,CA 95205 STOCKTON,CA 95205 <br /> Nome Phone :209-463-9242 <br /> Phone :209463-9242 Work Phone :209463-6390 <br /> District 001 -GUTIERREZ,STEVE Location Code 01 -STOCKTON <br /> APN 14716030LW Date Abated l (P -0,5— Inspector: _-_CI M 1j <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> I <br /> Complaint History <br /> Complaint status Code: �/ Attached But Not <br /> QL Scanned <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 14-ENFORCEMENT CASE-Transferred to ER 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 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> 6F>HD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCY 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> 08-UNABLE TO VERIFY 28-FOODBORNE ILLNE=SS-Unconfirmed <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Confirmed <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 1 <br /> a <br /> 5104.rpt - <br />