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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00022949 Site Location: 7500 W 11 TH ST Account ID: AR0008694 <br /> Received by: EE0000321 OLIVEIRA Received Date: 6/24/2005 Print nate: 6/24/2005 l 1:37:36AM <br /> Assigned To: EE0001699 YOAKUM Assigned Date: 6/24/2005 <br /> t: Pro ram/Element Ccde:1600-FOOD PROGRAM <br /> <br /> <br /> Nature of complaint. <br /> COOK WITH OPEN SORES ON HANDS IS PREPARING FOOD AND NOT WEARING GLOVES. <br /> Complaint Mode: P Complaint Mode Godes A-Agency Referral B-Bd of Supervisors i City Council C-Counter <br /> E-Code Enforcement M-Mail 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 7506 W 11TH ST RPIDBA 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 25015018 r <br /> Date Abated r'n.-' {j5 Inspector. J� Lox U� <br /> �Y 1 'I <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: SCANNED <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 16-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> 1'16 JEHD 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 FILL= <br /> 08-UNABLE TO VERIFY 26-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 /> Complaint History <br /> Attached But Not <br /> Scanned <br /> 5104.rp1 <br />