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Report#:5104 <br /> Complaint Investigation Form <br /> COMPLAINT ID: C00015451 Site Location: 1111 NAVY DR (ZACKY KITCHEI AccountID: <br /> I <br /> Receivedby: EE0006519 DISA Received Date: 1/29/2001 i <br /> Assigned To: EE000,334997 QUINLIN Assigned Date: 1129101 <br /> Program/Element Code: -4868' FOOD PROGRAM <br /> Complainant: <br /> <br /> j <br /> Nature of complaint: <br /> EMPLOYEE'S ARE BECOMING SICK,ALMOST VOMITING FROM THE SMELL COMING FRO ZACKY'S <br /> Complaint Mode P Complaint Mode Codes: A-Agency Referral B-Bd of Supervisors/City Council i E-Godo Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C-Counter P-Phone <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner: ' <br /> RP/DBA: ZACKY'S KITCHEN <br /> Site Location: 1111 NAW <br /> RP Address: 1111 NAW`DR <br /> STOCKTON,CA <br /> STOCKTON,CA <br /> Billing Address:: 1111 NAVY DR <br /> Phone: Phone: Hm: <br /> Wk: Number Not Specified <br /> District Location Code <br /> APN <br /> Date Abated <br /> Inspectory <br /> -NVALe- <br /> Send Referral to: <br /> Referral Address: <br /> DAL N <br /> Referral Letter Sent by.- <br /> Date: <br /> y.Date: <br /> Complaint Status Code: ru 1 �s C US <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-Letter Sent 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 /> EHD Permit Facility-See Linked Premise File 52- Lead Hazard Abatement in Progress(3) <br /> -Referred To Other Agency 53- Lead Hazard Visual Inspect Satisfactory (4) <br /> 08-Invalid/Unable To Verify 51 - Lead Hazard Work Plan Submitted(2) <br /> 09-Foodborne 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 Rle 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 /> Q104.rpt <br />