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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00022016 Site Location: 7500 W 11TH ST Account ID: AR0008694 <br /> Received by: EE0006519 DISA Received Date: 12/29/2004 Print Date:12/29/2004 10:50:43AM <br /> Assigned To: EE0001699 YOAKUM Assigned Date: 12/29/2004 <br /> Program/Element Code.,1600-FOOD PROGRAM <br /> <br /> <br /> Mature of complaint. <br /> SIGN IN BATHROOM SAY'S DO NOT FLUSH TOILET PAPER DOWN TOILET.COMPLAINANT MADE SURE THIS IS WHAT SIGN MEANT SHE <br /> ASKED WORKER THEY SPP THAT'S CORRECT THEY DON'T WANT EVEN TOILET PAPER PUT IN TOILET. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter <br /> E-Code Enforcement M-Mail!Correspondence O-Other EH Unit P-Phone <br /> ---------------------------------------- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0003209-CASA MENDOZA RESTAURANT Owner: OW0005422-MENDOZA,ABEL I <br /> Site Location 7500 W 11 TH ST RP/DBA CASA MENDOZA RESTAURANT <br /> TRACY,CA 95376 <br /> RP Address 24711 S CHRISMAN RD <br /> TRACY,CA 95376 <br /> Mailing Address: p0 BOX 101 Billing Address PO BOX 101 <br /> i <br /> TRACY,CA 95376 TRACY,CA 95376 <br /> Nome Phone :209-836-5630 j <br /> Phone :209-835-0863 Work Phone :209-835-0863 <br /> District 005-ORNELLAS,LEROY Location Code 03-TRACY <br /> APN 25015018 � <br /> Date Abated — 7 Inspector. <br /> i <br /> —————————————— T -----—————————————— ——————————————— <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint History <br /> Attached_Brut Not <br /> Complaint Status Code: scanII d <br /> I <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 CASK# <br /> 03-NAI SENT 16-LETTER SENT TO TENANT i <br /> 04-NOTICE TO ABATE ISSUED 17-15 DAY LETTER SENT <br /> O�5-ENFORCEMENT ACTION INITIATED 16-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> r 9 EHD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07.REFERRED TO OTHER AGENCY 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> 08-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Confirmed ; <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> Poik Al" <br /> 1l�_o 6V-4-' w _f <br /> nwt 5 cffi 01 -_ <br /> 5104.rpt <br />