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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00039211 Site Location: 1110 N MAIN Account ID. AR0000792 <br /> Received by: EE0000467 CARRUESCO <br /> Received Date: 2/9/2015 Print Date: 2/9/2015 12:37:08PM <br /> Assigned To: EE0005366 MEDINA Assigned Date: 2/9/2015 <br /> Proaram/Element Code:1600-FOOD PROGRAM <br /> Complainant MIKE Home Phone <br /> Address Work Phone . <br /> -Mail Address upc eC a gma,.conn <br /> Nature of com laint: <br /> on 02/05/15(C)ORDERED A BREAKFAST BURRITO. SOUR GARBAGE SMELL. ODOR WAS COMING FROM UNCLEAN PLATE AND <br /> SILVERWARE.SEE ATTACHED PHOTOS. <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 /> -------------- - ------ ----- ---------- -- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facilitv:FA0000794-TAQUERIA LA ESTRELLA Owner: OW0017389-FONSECA,JUAN <br /> Site Location ►110 N MAIN ST RP/DBA TAQUERIA LA ESTRELLA <br /> MANTECA,CA 95336 RP Address <br /> <br /> <br /> <br /> <br /> Phone :209-823-9000 Work Phone <br /> District 003-BESTOLARIDES Location Code <br /> APN 21821023 <br /> Date Abated �,�0 Inspector ID#: 53�� <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 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 02-OFFICE ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 03-NAI SENT 50-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 /> 0 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 />