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Complaint Investigation Form <br /> P 9 Report#:5104 <br /> COMPLAINT ID: C00031034 Site Location: 5648 N EL DORADO ST Account ID, AR0002179 <br /> Received by: EE0000321 OLIVEIRA Received Date: 9/28/2009 Print Date: 9/28/2009 2:03:45PM <br /> Assigned To: EE0006213 PEDRAZA Assigned Date: 9/28/2009 " <br /> Program/Element Code-1600-FOOD PROGRAM <br /> Complainant., ;ANONYMOUS Home Phone <br /> Address <br /> Work Phone <br /> —E-Mai[Address <br /> Nature of com Taint: <br /> KITCHEN IS FILTHY AND CLUTTERED. DIRTY EQUIPMENT IS NOT BEING CLEANED. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other,EH Unit P-Phone <br /> --------------- _ __ __ <br /> FACILITY INFORMATION . OWNER INFORMATION — — — <br /> Facility:FA0002I68-ST MARYS HIGH SCHOOL Owner: OW0001686-ST MARYS HIGH SCHOOL <br /> Site Location 5648 N EL DORADO ST RP/DBA ST MARYS HIGH SCHOOL <br /> STOCKTON,CA 95207 RP Address 5648 N EL DORADO <br /> Cross Street ELDORADO 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 i <br /> Date Abated d Inspector: Cn a <br /> -----`--- <br /> -- ------------- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> a <br /> �>Iwplaint History <br /> Complaint Status Code: �� Attached But Not <br /> 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 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> 04-NOTICE TO ABATE ISSUED 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> gfi-,ENFORCEMENT ACTION INITIATED 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> 06 HD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 28-FOODBORNE ILLNESS-Unconfirmed/No Major Violations <br /> 07-REFERRED TO OTHER AGENCY 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 08-UNABLE TO VERIFY 50-LEAD Assessment Performed-No Abatement Required <br /> 09-FOODBORNE ILLNESS 52-LEAD Abatement Reqired-See Program Record File <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File 97-Disaster Planning and Response <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 99-UNSPECIFIED-Old Complaint-No Original Found-Pre-tracking <br /> 12-DA Referred Complaint-See Violation Tracking Form CL-Case Closed <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE <br /> oa rat <br />