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Complaint Investigation Form k j.:� Report#;5104 <br /> COMPLAINT ID: C00015462 Site Location: 1110 N MAIN ST Account ID: AR0000792 <br /> Received by: EE0002685 BOOTH Received Date: 1/29/2001 I <br /> Assigned To: EE0002685 BOOTH Assigned Date: 1131101 <br /> Program/Etement Code: 1624-RESTAURANT/BAR 21-50 SEATS <br /> Complainant., <br /> <br /> <br /> Nature of complaint: <br /> EMPLOYEE WORKING AT FACILITY HAS HEPATITIS B AND SORES. <br /> Complaint Mode P Complaint Mode Codes: A-Agency Referral B-Bd of Supervisors/City Council` E-Cade Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0000794-LONG JOHN SILVERS#5268 Owner: OW0000473-LONG JOHN SILVERS INC i <br /> RP/DBA: LONG JOHN SILVERS <br /> Site Location: 1110 N MAIN ST <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> District 003-MOW,VICTOR Location Code 04-MANTECA i <br /> APN I <br /> Date Abated ] d <br /> Inspector <br /> 3: <br /> Send Referral to: I <br /> Referral Address: <br /> I' <br /> i <br /> S ' <br /> Referral Letter Sent by: <br /> Date: <br /> Complaint Status Code: <br /> r Z <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/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 File 56-Lead Hazard Abatement Complete (7) <br /> 13-Enforcement Case-Transferred To SOLID WASTE File 57-Lead Hazard Property Vacant W/Soil Contamination <br /> 14-Enforcement Case-Transferred To ER File 58- Lead Hazard Case-See Active File'For This Site <br /> I. <br /> 0104.rpt <br /> il, <br />