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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00026167 Site Location: 5648 N EL DORADO ST Account ID: AR0002179 <br /> Receivedby: EE0003600 BLACKWELL Received Date: 4/17/2007 Print Date: 4/17/2007 9:43:20AM <br /> Assigned To: EE0003474 VEGA Assigned Date. 4/17/2007 <br /> ProaramlEle Ant Code 1600-FOOD PROGRAM C �'� � <br /> Complainant: :PARENT OF ST MARYS HS STUDENT Nome Phone �l <br /> Address Work Phone <br /> Nature of complaint. <br /> ABOUT A MONTH AGO(C)OBSERVED THE FOLLOWING IN THE KITCHEN: DIRTY COUNTER TOPS,COCKROACHES,DISHWASHER LEAKING <br /> FLUID(NOT WATER)ONTO FLOOR, ICE MACHINE MOTOR LEAKING A FLUID DIRECTLY ABOVE WHERE THE ICE IS KEPT,WALK-IN FREEZER <br /> SHELVES ARE FILTHY,AND OLD/STALE FRENCH FRIES WERE LEFT IN THE FRYING EQUIPMENT. (SEE ATTACHED FAX). <br /> Complaint Mode: I Complaint Mode Codes A-Agency Referral B-Bd of Supervisors l City Council C-Counter <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FAGO02168-ST MARYS HIGH SCHOOL Owner: OW0001686-ST MARYS HIGH SCHOOL <br /> Site Location 5648 N EL DORADO ST RPIDBA ST MARYS HIGH SCHOOL <br /> STOCKTON,CA 95207 RP Address 5648 N ELDORADO <br /> STOCKTON,CA 95207 <br /> Mailing Address: PO BOX 7247 Billing Address 5648 N EL DORADO <br /> STOCKTON,CA 95267-0247 STOCKTON,CA 95207 <br /> Home Phone <br /> Phone :209-957-3340 Work Phone ; <br /> District 002-RUHSTALLER,LARRY Location Code 01 -STOCKTON <br /> APN 10209001 <br /> Date Abated S -07 Inspector: © -46 7 <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: r <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 16-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> EHD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> REFERRED TO OTHER AGENCY 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> oa-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed f No Major Violations <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 30-15 Day Letter Sent-Confirmed Complaint <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 31-15 Day Letter Sent-Alleged Complaint <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 510a.rpt <br /> s <br />