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Complaint Investigation Form Ra ort#:5104 <br /> COMPLAINT ID: 000028778 Site Location: 2425 W KETTLEMAN LN Account ID, AR0020965 <br /> Received by: EE0001788 VAN FLEET Received Date: 8/5/2008 Print Date: 8/5/2008 11:22:30AM <br /> Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date: 8/5/2008 <br /> Program/Element Code:1600-FOOD PROGRAM <br /> Complainant: : <br /> <br /> Nature of complaint. <br /> (C)STATED THAT SHE WENT THROUGH THE DRIVE-THRU THIS MORNING,AND THE EMPLOYEE WORKING AT THE WINDOW HAD A STY IN <br /> HER EYE. (C)STATED THAT THE EMPLOYEE KEPT WIPING HER EYE WITH A PAPER TOWEL AND CONTINUE WORKING WITHOUT <br /> WASHING HER HANDS. -(C)DOES NOT NEED A CALL BACK. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors t City Council C-Counter <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> --- -------- --------- _----- -- <br /> ---- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0012662-JACK IN THE BOX#4301 Owner. OW0000819-YADAV,ANIL <br /> Site Location 2425 W KETTLEMAN LN RPIDBA <br /> LODI,CA 95242 RP Address <br /> <br /> <br /> <br /> <br /> <br /> District 004-VOGEL,KEN Location Code 02-LODI <br /> APN 02741008 <br /> Date Abated 3-6,-08 — Inspector- . <br /> ----- ----- ------ <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 14-ENFORCEMENT CASE-Transferred to ER 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 /> ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> 06 EHD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCY 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> 08-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed f No Major Violations <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Major Violations Identified <br /> I 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 30-15 Day Letter Sent-Confirmed Complaint <br /> Complaint History <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 31-15 bay Letter Sent-Alleged Complaint Attached But Not <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 50-LEAD HAZ EVALUATION REQUIRED(1) Scanned <br /> , <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 510a t <br />