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Complaint Investigation Form 1.1.4 Report#:5104 <br /> COMPLAINT ID: C00014149 Site Location: 1950 W 11TH ST Account/D: AR0002542 <br /> Receivedby: EE0000794 MATHEW Received Data: 5/17/2000 <br /> Assigned To: EE0003497 QUINLIN Assigned Date: 5/17/00 <br /> Program/Element Code: ,Wr -FOOD PROGRAM/61? <br /> Complainant: <br /> <br /> <br /> <br /> <br /> PURCHASED GROUND BEEF FROM FACILI Y ON 15TH. FOUND BLUE STREAKS AN PARTS OF A BALL POINT PEN IN MEAT. <br /> COMPLAINAND IS SAVING MEAT AND FOREIGN OBJECTS <br /> Complaint Mode P Complaint Mode Codes A-Agency Referr. B-Bd of Supervisors/Citi C-Count( E-Code Enforcem( <br /> M-Mail/Correspond( O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0002980-SAFEWAY STORES#1264 OW0000429-SAFEWAY INC <br /> Site Location: 1950 W 11TH ST <br /> TRACY,CA 95376 < ,i, tip RP Address: 47400 KATO RD <br /> PO BOX 29096 <br /> Mailing Address: I 'I I�� <br /> PHOENIX,AR 85038-9096 n Billing Address: PO BOX 29096 <br /> Phone: 1st: 209-239-9327 �u�'('""" PHOENIX,AR 85038-9096 <br /> Phone: Hm: 209-239-9327 <br /> Wk: <br /> District: 005-CABRAL, ROBERT Location Code: 03-TRACY <br /> APN. <br /> Date Abated: <br /> Inspector. <br /> Send Referral to: <br /> Referral Letter Sent by: <br /> Referral Address: <br /> Date: <br /> Complaint Status Code: U D <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 /> 07-Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) <br /> 08-Invalid/Unable To Verify 51 - Lead Hazard Work Plan Submitted(2) <br /> 09- 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 /> )c 1 <br /> r <br /> 0104.rpt <br />