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Complaint Investigation Form Report# 5104 <br /> COMPLA(IV'f ID: C00043059 Site Location: 1230 W KETTLEMAN LN Account lD AR0014570 <br /> Receivedby: EE0001788 CASTANEDA Received Date: 3/7/2017 Print Date. 3/7/2017 10:43:54AM <br /> Assigned To: EE0001084 RAMIREZ Assigned Date: 3/7/2017 <br /> Prooram/E/ement Code:1600-FOOD PROGRAM <br /> Complainant: :LANCE Home Phone 209-663-2548 <br /> Address Work Phone <br /> -Mail Address <br /> Naturoof complaint: <br /> COMPLAINANT ALLEGES THEY WERE AT THE FACILITY ON 3/7/2017 AT APPROXIMATELY 7:30 AM AND OBSERVED THE CUSTOMERS AT <br /> THE TABLE NEXT TO THEM CONSUMING PANCAKES.WHEN THE CUSTOMERS PICKED UP THE SYRUP THAT IS STORED ON THE TABLE, <br /> TWO BABY COCKROACHES RAN OUT.COMPLAINANT STATED THAT THEY COMPLAINED TO THE WAITRESS WHO THEY CLAIM ACTED LIKE <br /> IT WAS NO BIG DEAL AND WALKED AWAY.PLEASE CALL COMPLAINANT WITH FINDINGS. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> I-Internet/Email S-Shentrs Office <br /> - - - -- -- - --------------------- ------------- <br /> PROPERTY INFORMATION OWNER INFORMATION <br /> Facility:FA0003926-IHOP Owner: OW0006538-LAXMI US 1234 FOOD CORP <br /> Site Location 1230 W KETTLEMAN LN RPIDBA [HOP <br /> LODI,CA 95240 RP Address 2213 KELSO PEAK AVE 170 <br /> Close Street HAM BAKERSFIELD,CA 93304 <br /> Mailing Address: 1230 KETTLEMAN LN Billing Address 1230 KETTLEMAN LN <br /> LODI,CA 95240 LODI,CA 95240 <br /> Home Phone <br /> Phone :209-369-1361 EXT: 0 Work Phone : - <br /> District 004-WINN,CHARLES Location Code 02-LODI <br /> APN 060040 01 nJ/1�� <br /> Date Abated z ` 1 Inspector ID#: 1'-'�V r tr Vl• -- <br /> Send Refema/to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Coder <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 /> 68-Violations Cited-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> Refferred to Other Agency <br /> OB Unable to Verify 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: ate: Updated by: Date. <br /> Z-/—/ <br /> 51G4,1 <br /> so4,p <br />