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Complaint Investigation Form Report#:5104 <br /> COMPLA T ID: C00019467 Site Location: 2180 E MARIPOSA RD Account 1D: AR0002852 <br /> Received by: EE0003600 CAMPBELL Received Date: 8/15/2003 Print Date: 8/15/2003 4:44:42PM <br /> Assigned To: EE0006213 PEDRAZA Assigned Date: 8/15/2003 <br /> ProaramlElemant Code:1618-RETAIL MKT>2000 SOFT (PREPKGD I LTD PREP) <br /> Complainant: : <br /> <br /> Nature of com Taint: <br /> THE ONE BATHROOM IN THE STORE HAS A BROKEN TOILET AND IT SMELLS REALLY BAD.WATER IS FLOWING INTO A DRAIN THAT IS ON <br /> THE FLOOR(PROBABLY FROM THE TOILET). <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors f City Council C-Counter <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> --------- --------------------------------------- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0003278-KMART#31.74 Owner: OW0002315-KMART CORP <br /> Site Location 2180E MARIPOSA RD RPIDBA : <br /> STOCKTON,CA 95205 RP Address <br /> <br /> <br /> <br /> <br /> <br /> <br /> APN <br /> Date Abated Q�1`b�(� inspector: oz—1 7, <br /> -------------------------- - ---------------------- <br /> Send Referral to DD Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Coder <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 /> 05-ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> 6EHD PERMIT FACILITY-see Linked PREMISE FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCY 28-FOODBORNE ILLNESS-Unconfirmed <br /> 08-UNABLE TO VERIFY 29-FOODBORNE ILLNESS-Confirmed <br /> 09-FOOQSORNE ILLNESS 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 51 -LEAD HAZ WORK PIAN SUBMITTED(2) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 52-LEAD HAZ ABATEMENT IN PROGRESS(3) 11 <br /> 12-ENFORCEMENT CASE-Transferred 10 LIQUID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 54-LEAD HAZ DUST EVALUATION SATISFACTORY(5) <br /> I <br /> 5104,rpt <br /> i <br />