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k <br /> �' - • i' �' Report#: 5104 <br /> Complaint Investigation Form <br /> I ' <br /> COMPLAINT ID: C00015966 Site Location: 1950 W 11TH ST Account ID: AR0002542 <br /> Received by: EE0006519 DISA Received Date: 5/21/2001 <br /> Assigned To: EE0003497 QUINLIN Assigned Date: 5/12/01 <br /> Program/EfementCode: 1619-RETAIL MKT X1000 SQ FT(MULTIPLE DEPTS) <br /> Complainant: <br /> <br /> <br /> <br /> Nature of complaint: w <br /> COCKROACHS IN BAKERY,ON FLOOR AND COUNTER,THEY USUALLY SPRAY RIGHT AWAY BUT NOT THIS TIME. <br /> Complaint Mode P Complaint Mode Codes: A-Agency Referral B-Bd of Supervisors/City CouncilE-Code Enforcement <br /> i <br /> M-Mail/Correspondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0002980-SAFEWAY STORES#1264 Owner: OW0000429 SAFEWAY INC <br /> RP/DBA: <br /> Site Location: 1950 W 11TH ST T E <br /> RP Address: 47400 KATO RD <br /> TRACY, CA 95376 <br /> FREMONT;CA 94537 <br /> Mailing Address: PO BOX 29096 <br /> PHOENIX,AR 85038-9096 Billing Address:: PO BOX 29096 i 1. <br /> PHOENIX,AR 85038-9096 <br /> Phone:1st: 209-239-9327 Phone: Hm: 209-239-9327 , <br /> Wk: 209-239-9327 <br /> District 005-BEDFORD,LYNN Location Code 03-TRACY <br /> APN }� <br /> Date Abated "V I <br /> lnspector <br /> t <br /> Send Referral to: <br /> Referral Address: <br /> Referral Letter Sent by: <br /> Date: <br /> Complaint Status Coder <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 1 Unable To Verify 51 -Lead Hazard Work Plan Submitted(2)11 <br /> 09-Foodbome 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):, 4 <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 /> is .r <br /> I <br /> 0104.rpt <br />