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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00019118 Site Location: 7500 W 11TH ST Account ID: AR0008694 <br /> Received by: EE0003361 FLOHRSCHUTZ Received Date: 6/9/2003 Print Date: 6/12/2003 4:23:17PM <br /> E Assigned To: EE0003361 FLOHRSCHUTZ Assignad Date: 6/9/2003 <br /> Program/Element Code 1624-RESTAURANT/BAR 21-50 SEATS <br /> <br /> <br /> Nature of complaint. <br /> THERE WAS A FIRE ON 09/08/03 @ APPROX 5:30PM. ER RECEIVED THE CALL. STORAGE AREA AND FREEZERS DAMAGED. <br /> Complaint Mode: A Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter <br /> L i E-Code Enforcement M-Mali 1 Correspondence O.Other EH Unit P-Phone <br /> ----------------- ----------- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0003209-CASA MENDOZA RESTAURANT Owner: OW0005422-MENDOZA,ABEL <br /> Site Location 7500 W 11 TH ST RP/DBA CASA MENDOZA RESTAURANT <br /> TRACY,CA 95376 RP Address 24711 S CHRISMAN RD <br /> TRACY,CA 95376 <br /> Mailing Address: PO BOX 101 Billing Address PO BOX 101 <br /> TRACY,CA 95376 TRACY,CA 95376 <br /> Home Phone :209-836-5630 <br /> Phone :209-835-0863 Work Phone :209-835-0863 <br /> District 005-ORNELLAS,LEROY Location Code 03-TRACY <br /> APN <br /> Date Abated Gi ��L, Inspector '53(�p <br /> Send Referral to I ✓ Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: D <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 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> 06-EHD PERMIT FACILITY-see Linked PREMISE FILE 28-FOODBORNE ILLNESS-Unconfirmed <br /> 07-REFERRED TO OTHER AGENCY 29-FOODBORNE ILLNESS-Confirmed <br /> 08-UNABLE TO VERIFY 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 09-FOODBORNE ILLNESS 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 54-LEAD HAZ DUST EVALUATION SATISFACTORY(5) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 55-LEAD HAZ MONITORING SCHED(6) <br /> L <br /> o <br /> o � <br /> 5104.rpt <br />