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CO0015917
EnvironmentalHealth
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1600 - Food Program
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CO0015917
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Entry Properties
Last modified
9/13/2022 8:19:08 AM
Creation date
2/8/2019 9:35:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0015917
PE
1619
FACILITY_ID
FA0001705
FACILITY_NAME
COSTCO WHOLESALE #38
STREET_NUMBER
1616
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
Stockton
Zip
95210
ENTERED_DATE
5/10/2001 12:00:00 AM
SITE_LOCATION
1616 E HAMMER LN
RECEIVED_DATE
5/8/2001 12:00:00 AM
P_LOCATION
01
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\H\HAMMER\1616\CO0015917.PDF
Tags
EHD - Public
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} <br /> `+ Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00015917 Site Location: 1616 E HAMMER LN Account ID: AR0o01704 <br /> i <br /> Receivedby.• EE0000794 MATHEW Received Date: 5/8/2001 <br /> Assigned To: EE0000321 OLIVEIRA Assigned Date: 5110/01 <br /> Proyram/Element Code: 1619-RETAIL MKT X1000 SQ FT(MULTIPLE DEPTS) <br /> Complainant., <br /> <br /> <br /> i <br /> Nature of complaint.- <br /> DIAGNOSED <br /> omplaint.DIAGNOSED WITH SALMONELLA ON 05-05-01. BOUGHT AND ATE TYSON BRAND PRECOOKED CHICKEN BREAST PURCHASED ON <br /> 04-28-01 BECAME ILL 04-29-01 WITH BLOODY DIARRHEA. FOOD WAS HEATED WELL AT HOME. <br /> Complaint Mode P �rComplain t Mode Codes: A-Agency Referral B-Bd of Supervisors/City Council 'I E-Code Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C,counter P-Phone <br /> 1 .P <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility; FA0001705-COSTCO WHOLESALE#38 Owner: OW0001336-COSTCO WHOLESALE CORPORATION <br /> RP/DBA: w d!L <br /> Site Location: 1616E HAMMER LN h v <br /> RPAddress: 999 CAKE DR <br /> STOCKTON,CA 95210 <br /> ISSAQUAH,WA 98027 <br /> Mailing Address: 999 LAKE DR <br /> p . <br /> 8illingAddress:: 999 LAKE DRIVE <br /> ISSAQUAH,WA 98027 <br /> ISSAQUAH,WA I 98027 <br /> Phone:ist: 209-478-2040 Phone: Hm: 206-803-8100 <br /> Wk: 425-313-8100 <br /> District Location Code 01 -STOCKTON <br /> APN <br /> DateAbated S�CS�OI <br /> Inspector !I <br /> i <br /> it <br /> r <br /> Send Referral to: <br /> F <br /> Referral Address: I <br /> i <br /> .i <br /> K I' <br /> Referral Letter Sent by: <br /> 'i <br /> Date: <br /> k � <br /> Complaint Status Code: E I' <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 Sent 16-tetter Sent To Tenant <br /> 04-Notice To Abate Issued 17-15-Day Letter Sent ! i, <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) I <br /> 07,Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) <br /> nvalid 1 Unable To Verify 51 -Lead Hazard Work Plan Submitted(2) :I <br /> 09 Foodborne Illness 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> 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 WlSoil Contamination <br /> 14-Enforcement Case-Transferred To ER File 58-Lead Hazard Case-See Active File For.This Site <br /> i <br /> Ii <br /> 0104.rpt !� <br /> 3, <br />
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