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Complaint Investigation Form Report#:SiOa <br /> WMPLAINT 1D: C00018079 Site Location: 7939 W 11 TH ST Account ID: AR0002789 <br /> Received by: EE0007380 SH1H `„ Received Date. 9/24/2002 <br /> Assigned To: EE0009157 BA ;;••LOS �U4� C- Assigned Date., 9/24/2002 <br /> Program/Element,Code: 1600-FOOD PROGRAM <br /> Complainant: <br /> <br /> Nature ofcomplaint: -*ZD q t-aAE,1e A—A 41MTPSS 441;5 <br /> THERE IS NO AIP GAP IN ICE MAKER <br /> Complaint Mode P Complaint Made Codes: A-Agency Referral B-Bd of SuperAsors/City Council E-Code Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0003221 -JACKS PLACE Owner: OW0002400-MAH,GUEY JACK <br /> RP/DBA: JACKS PLACE <br /> Site Localion: 7939 W 11TH ST <br /> TRACY,CA 95376 RPAddress: 31 E GRANT LINE RD <br /> Mailing Addrgss: 7939 W ELEVENTH ST TRACY,CA 95376 <br /> TRACY,CA 95376 Rifling Address:: 31 E GRANT LINE RD <br /> TRACY,CA 95376 <br /> Phone:1st: 209-832-3392 Phone., <br /> Wk: 209-832-3399 <br /> District 005-BEDFORD,LYNN Location Code 99-UNINCORPORATED AREA <br /> APN <br /> Date Abated �� a <br /> inspector �J <br /> Send Referral to: <br /> Referral Address. <br /> r <br /> Referral Letter Sent by: <br /> Date: <br /> Complaint Status Code: <br /> 01 -Field Abated 10-Substandard Property-See HOUSING ABATEMENT File <br /> 02-Office Abated 15-Active Housing Case-New Complaint See Active Case# <br /> 03-NAI Sont 16-Loltef SoN To Tenant <br /> 04-Notice To Abate Issued 17-15-Day Letter Sent <br /> 05-Enforcement Action Initiated 50-Lead Hazard Evaluation Required(1) <br /> 06-EHD Permit Facility-See linked Premise File 52-Lead Hazard Abatement In Progress(3) <br /> 07-Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) <br /> 08-Invalid/Unable To Verify 51 -Lead Hazard Worts Plan Submitted(2) <br /> 09-Foodbome illness # 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> 11-Multiple Complaints-See Active Case# 55-Lead Hazard Monitoring Schedule(6) <br /> 12-Enforcement Case-Transferred•To LIQUID WASTE File 56-Lead Hazard Abatement Complete(7) <br /> 13.-Enforcement Case-Transferred To SOLID WASTE File 57-Lead Hazard Property Vacant W/Soil Contamination <br /> 14-Enforcement Case-TransferredToER File 58-Lead Hazard Case-See Active File For This Site <br /> 5104.rpf <br />