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CO0031850
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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CO0031850
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Entry Properties
Last modified
11/19/2024 10:21:01 AM
Creation date
2/7/2019 12:42:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0031850
PE
1600
FACILITY_ID
FA0002980
FACILITY_NAME
SAVE MART #90
STREET_NUMBER
1950
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23402010
ENTERED_DATE
4/7/2010 12:00:00 AM
SITE_LOCATION
1950 W 11TH ST
RECEIVED_DATE
4/7/2010 12:00:00 AM
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\E\ELEVENTH\1950\CO0031850.PDF
Tags
EHD - Public
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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00031850 Site Location: 1950 W 11TH ST Account ID; AR0002542 <br /> Receivedby; EE0007541 FIELD Received Date; 4/7/2010 Print Date: 4/7/2010 2:46:10PM <br /> Assigned To: EE0001699 YOAKUM Assigned Date; 4/7/2010 <br /> Program/Element Code:1600-FOOD PROGRAM <br /> Complainant: : <br /> <br /> <br /> Nature of complaint. <br /> (C)PURCHASED INFANT FORMULA ABOUT TWO WEEKS AGO AND HIS INFANT BECAME ILL. INFANT'S DR SUSPECTED THAT IT WAS THE <br /> FORMULA THAT CAUSED ILLNESS. FORMULA BEST BY DATE WAS THE BEGINNING OF MARCH 2010. (C)COMPLAINED TO FEMALE <br /> MANAGER AFTER INFANT BECAME ILL. TODAY(C)WAS AT STORE AND SAW BEST BUY DATES ON FORMULA THAT SAID APRIL 1,2010. <br /> Complaint Mode' P Complaint Made Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail I Correspondence O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0002980-SAVE MART#90 Owner: OW0000369-SAVE MART SUPERMARKETS <br /> Site Location 1950 W 11TH ST RP/DBA i <br /> TRACY,CA 95376 RPAddress 1800 STANDIFORD AVE <br /> Cross Street EAi FI. CORAL LANAA& 1 EL V A MODESTO,CA 95350-0180 <br /> Mailing Address: PO BOX 4278 Soling Address PO BOX 4278 <br /> MODESTO,CA 95352-4278 MODESTO,CA 95352-4278 <br /> Nome Phone :209-577-1600 <br /> Phone :209-577-1600 Work Phone :209-574-6275 <br /> District 005-ORNELLAS,LEROY Location Code 03-TRACY <br /> APN 23402010 <br /> Date Abated 0,16 Inspector.' <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint HistorY <br /> Attached But Not <br /> Complaint Status Code: scanned <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 50-LEAD Assessment Performed-No Abatement Required <br /> 02-OFFICE ABATED 52-LEAD Abatement Regired-See Program Record File <br /> 03-NA!SENT 97-Disaster Planning and Response { <br /> 04-NOTICE TO ABATE ISSUED 99-UNSPECIFIED-Old Complaint-No Original Found-Pre-tracking <br /> 66>EHD FACILITY-see Linked PROGRAM FACILITY FILE CL-Case Closed <br /> 07-REFERRED TO OTHER AGENCY <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 29-FOODBORNE ILLNESS-Major Violations Identified <br /> ' 1 <br /> 510 p1 ' <br />
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