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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: 000028308 Site Location: 7500 W 11TH ST Account ID: AR0008694 <br /> i <br /> Received by: EE0007541 FIELD Received Date: 5/20/2008 Print Date: 5/20/2008 4:10:42PM <br /> Assigned To: EE0001699 YOAKUM Assigned Date: 5/20/2008 <br /> Program/Element Code:1600-FOOD PROGRAM <br /> <br /> <br /> Nature of complaint., <br /> AT NOON TODAY,5120108,(C)WAS AT FACILITY AND OBSERVED THE FOLLOWING: THE MEN'S TOILET DID NOT LOOK LIKE IT HAD BEEN <br /> FLUSHED IN OVER A WEEK;(C)WAS SERVED ICE TEA IN A GLASS THAT LOOKED LIKE IT HAD DRIED VOMIT ON IT;THE FLOOR HAD FOOD <br /> AND TRASH ON IT,AND THE TABLES WERE DIRTY. <br /> Complaint Mode.- P Complaint Mode Codes A-Agency Referral B-8d of Supervisors I City Council C-Counter I <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0003209-CASA MENDOZA RESTAURANT Owner: OW0005422-MENDOZA,ABEL <br /> Site Location 7500 W 11TH ST RP/DBA : ` <br /> TRACY,CA 95376 RP Address 24711 S CHRISMAN RD <br /> TRACY,CA 95304 <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 it <br /> Date Abated 5r2'^O8 Inspector � $Kk� <br /> --� <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code:f j� <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 Thank <br /> Q5 ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE �uI <br /> 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 UEC PROGRAM FILE <br /> 08-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed 1 No Major Violations <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 30-15 Day Letter Sent-Confirmed Complaint 0017 plaint Histo <br /> ty <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 31-15 Day Letter Sent-Alleged Complaint <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 50-LEAD HAZ EVALUATION REQUIRED(1) Attached But Not <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) Sued <br /> I� <br /> l <br /> 5104.rpt <br /> i <br />