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Complaint Investigation Form Report#:5104 <br /> k <br /> COMPL--HINT ID: 00030235 Site Location: 140 E HARDING WAY Account ID: AR0001468 <br /> Received by: EE0007380 SHIH Received Date: 5/6/2009 Print Date: 5/6/2009 4:28:19PM <br /> Assigned Ta: EE0001420 MENDE Assigned Date: 51$/2009 <br /> Prooram/ElementCope:1600-FOOD PROGRAM <br /> Complainant: :DAVID BREGANTE Home Phone : 209-337-8608 <br /> Address Work Phone <br /> Nature of com faint: <br /> AT 5 PM ON 5/1109,(C)ARE PORK, BARBECUE CHICKEN AND PEACHES WITH THOUSAND ISLAND DRESSING. (C)STATED THE CHICKEN <br /> WAS NOT COMPLETELY COOKED WITH RED BY THE BONES. (C)WAS ILL WITH FOOD POISONING FROM 11:30 PM ON 511109 TO 6:30 AM <br /> THE NEXT DAY. (C)STATED THERE IS NO ICE ON ICE TABLE. -(C)REQUESTS A CALL BACK AFTER INSPECTION. <br /> Complaint Mode: pLComplaint Mode Codes A Agency Referral B-Bd of Supervisors I City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> -------------------------------------- <br /> FACILITY <br /> ------ ---- — ---------- w -- ---- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0001469-GONGS RESTAURANT Owner: OW0001146-LEI,PAUL <br /> Site Location 140 E HARDING WAY RP/DBA GONGS RESTAURANT <br /> STOCKTON,CA 95204 RPAddress 5207 BARBADOS CT <br /> Cross Street HARDING STOCKTON,CA 95210 <br /> Mailing Address. 140 E HARDING WAY Billing Address 5207 BARBADOS CT <br /> STOCKTON,CA 95204 STOCKTON,CA 95210 <br /> Home Phone <br /> Phone :209-464-0953 Work Phone <br /> District 001-VILLAPUDUA Location Code 01-STOCKTON <br /> APN 13902015 <br /> Date Abated S. 7 -G [ Inspector:' —ALjo 7*lmk <br /> ----------------------------------------- <br /> — <br /> Send Referral to 1 Referral Letter Sent by <br /> Reterral Address Date: <br /> Complaint Status Coder <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 /> VH <br /> FORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> D 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 1 No Major Violations <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Major Violations Identified Complaint History <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 30-15 Day Letter Sent-Confirmed Complaint Attached But Not <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 31-15 Day Letter Sent-Alleged Complaint Scanned <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 50-LEAD HAZ Environmental Investigation Performed <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 52-LEAD HAZ Abatement-See Active Program Record File <br /> 61/'rpt <br />