Laserfiche WebLink
Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00039020 Site Location: 2449 W KETTLEMAN LN Account ID AR0041568 <br /> Received by: EE0009058 LOWE Received Date: 12/26/2014 Print Date: 12/26/2014 2:49:58PM <br /> Assigned To: EE0004589 LINHARES Assigned Date: 12/26/2014 <br /> Program/Element Code 1600-FOOD PROGRAM <br /> <br /> <br /> <br /> Nature of complaint: <br /> ON 12/25/14 @ 12PM 4 ADULTS CONSUMED 3 DELI SANDWICHES,(1)TURKEY,(2)PASTRAMI:ORDER OF CHICKEN WINGS. 12/26 @ 3AM <br /> ALL BECAME ILL WITH VOMITING, DIARRHEA,CHILLS, HEADACHE,STOMACH CRAMPS. FATHER HOSPITALIZED 7/26/14 @ 7:30 AM. (STILL <br /> IN ER).FATHER ATE 1 OF THE 2 PASTRAMI. PLEASE CALL(C)AFTER INSPECTION. <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-Sheriffs Office <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Faeilit,: FA0022701-SAFEWAY#1648 Owner: OW0000429-SAFEWAY INC <br /> Site Location 2449 W KETTrLEMAN LN RP/DBA <br /> LODI,CA 95242 RP Address 5918 STONERIDGE MALL RD <br /> Cross Street PLEASANTON,CA 94588 <br /> Mailing Address: PO BOX 29096 MS 6516 Billing Address PO BOX 29096 MS 6516 <br /> PHOENIX,AR 85038-9096 <br /> Home Phone :925467-3000 <br /> Phone :209-367-7875 Work Phone <br /> District 004-VOGEL,KEN Location Code <br /> APN 02741005 <br /> Date Abated 12 2 ' Inspector ID#P- Y VVI <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 01-FIELD ABATED 029FOODBORNE <br /> FOODBORNE ILLNESS-No Major Violations Identified <br /> 02-OFFICE ABATED ILLNESS-Major Violations Identified <br /> 03-NAI SENT LEAD Assessment Performed-No Abatement Required <br /> 04-NOTICE TO ABATE ISSUED 52-LEAD Abatement Regired-See Program Record File <br /> 05-DA-ENFORCEMENT ACTION INITIATED 97-Disaster Planning and Response <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-REFERRED TO OTHER AGENCY CL-Case Closed <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11 -Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 5104 rpt <br />