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s <br /> Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: 000035645 Site Lobation 140 E HARDING WAY AccountlD: AR0001468 <br /> Received by: EE0090753 MARTINEZ Received Date: 11/5/2012 Print Date: 1116!2012 8:06:13AM <br /> Assigned To: EE0006213 PEDRAZA Assigned Date: 11/5/2012 <br /> Program/Element ode:1600-FOOD PROGRAM <br /> Complainant: : <br /> <br /> � <br /> Nature of complaint: <br /> ENTIRE FACILITY 15 FILTHY <br /> ! Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail I Correspondence O-Other EH Unit P-Phone <br /> I-Internet I Email S-Sheriff's Office <br /> T <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FAOOO1469-GONGS RESTAURANT Owner: OW0001146-LEE,PAUL <br /> Site Location 140 E HARDING WAY RP/DBA GONGS RESTAURANT <br /> STOCKTON,CA 95204 RP Address <br /> <br /> <br /> <br /> Home Phone <br /> I Phone :209464-0953 Work Phone <br /> DistrictLocation Code <br /> AP141 <br /> Date Abated +/J' 6(Olt s/ Inspector ID#; <br /> q_ <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> i <br /> i Complaint Status Code- <br /> j Circle appropriate Status Code <br /> f 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> i 01-FIELD ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 02-OFFICE ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 03-NAI SENT 50-LEAD Assessment performed-No Abatement Required <br /> 04-NOTICE TO ABATE ISSUED 52-LEAD Abatement Regired-See Program Record Fite <br /> 05-DA-ENFORCEMENT ACTION INITIATED 97-Disaster Planning and Response <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-REFERRED TO OTHER AGENCY CL-Case Closed <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARDIUNSECURED-See Housing File <br /> 11 -Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> f <br /> E <br /> I k <br /> 5104.rpt <br /> f- <br />