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Complaint Investigation Form Report 5104 <br /> COMPLAINT ID: C00017709 Site Location: 2425 W KETTLEMAN LN Account ID: AR0020965 <br /> Received by: EE0006519 DISA Received Date: 7/8/2002 <br /> Assigned To: EE0000467 CARRUESCO Assigned Date: 7/8/2002 <br /> PrograrWElement Code: 1625-RESTAURANT/BAR51-100 SEATS <br /> Complainant: <br /> . <br /> Nature of complaint. <br /> FAMILY WENT OUT FOR DINNER 07-07-02,COMPLAINANT AND HER HUSBAND BECAME VERY ILL AFTER EATING.STOMACH CRAMPS, <br /> VOMITING AND DIARRHEA.THEY WERE THE ONLY ONES THAT HAD BEEF TACO'S. <br /> Complaint Mode P Complaint Made Codes: A-Agency Referral B-Bd of Supervisors/City Council E-Code Enforcement <br /> M-MaillCorrespondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0012662-JACK IN THE BOX#4301 Owner: OW0000133-JACK IN THE BOX INC <br /> RP/DBA: JACK IN THE BOX <br /> Site Location: 2425 W KETTLEMAN LN <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> District 004-SEIGLOCK,JACK Location Code 02-LODI <br /> APN 027-040-90 <br /> Date Abated -1_(0 - o)'- <br /> lnSpeCfar_ <br /> Send Referral to: <br /> Referral Address: <br /> Referral Letter Sent by: <br /> Date: <br /> Oq <br /> Complaint Status Code: <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 /> 06-EHD Permit Facility-See Linked Premise File 52-Lead Hazard Abatement in Progress(3) <br /> 07-Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) <br /> 08-Invalid I Unable To Verify 51-Lead Hazard Work Plan Submitted(2) <br /> 09-Foodbome 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 File 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 /> s1o4.ryt <br />