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[ � Complaint Investigation Form Report# 5104 <br /> COMPLAINT ID: C00041594 Site Location: 140 E HARDING WAY AccountlD AR0001468 <br /> Receivedby: EE0000025 SEDRA Received Date: 5/26/2016 Print Date: 5/26/201611:58:15AM <br /> Assigned To: EE0008999 HUYNH Assigned Date: 5/26/2016 <br /> PivoramiElement Code1600-FOOD PROGRAM <br /> Complainant: : <br /> <br /> <br /> Nature ofcomplaint: <br /> COMPLAINANT ALLEGES THAT THEY WERE AT THE RESTAURANT ON 5/25/2016 AT APPROXIMATELY 11:30 AM.COMPLAINANT STATED <br /> THAT THE FOIL CHICKEN TASTED LIKE THE MEAT WAS GOING BAD.COMPLAINANT DID NOT BECOME ILL. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement WMail/Correspondence O-Other EH Unit P-Phone <br /> I-Intemet/Email S-Shenfrs Office <br /> — ----_— --__ —_— — — _--___---- <br /> PROPERTY INFORMATION OWNER INFORMATION <br /> Facility:FA0001469-GONGS RESTAURANT Owner OW0001146-LEL PAUL <br /> Site Location 140 E HARDING WAY RPiDBA GONGS RESTAURANT <br /> STOCKTON,CA 95204 RP <br /> <br /> <br /> <br /> <br /> - - <br /> District 001-V ILLAPUDUA,CARLOS Location Code 01-STOCKTON <br /> APN 13902015 <br /> Date Abated vq/1/ (Q Inspector lD#: *V14 nh <br /> Send Referral to 1 r� Referral Letter Sent by <br /> Referral Address Date.' <br /> Complaint Status Code: 0 <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 01-Field Response-Violations Cited and Corrected 28-Alleged FBI-No Major Violations Identified <br /> 02-Office Response Only 29-Alleged FBI-Major Violations Identified <br /> 50-LEAD Assessment Performed-No Abatement Required <br /> 52-LEAD Abatement Reqired-See Program Record File <br /> 97-Disaster Planning and Response <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-Refferred to Other Agency <br /> 08-Unable to Verity Alleged Complaint MN-EHD Monitoring Status <br /> PD-Permit Issued-Pending Well Installation <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File RS-Resolved-New Well Installed <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> ompaint Reviewed by: Date'. p ate ate' lo_ J� <br /> 5104.rpt <br />