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Complaint Investigation Form Report#:5104 <br />�r_OMPLAINT ID: C00019600 Site Location: 2180 E MARIPOSA RD AccountlD: <br /> s <br /> Receivedby: EE0000321 OLIVEIRA Received Date: 9/4/2003 Print Date: 9/8/2003 12:15:09PM <br /> Assigned To: EE0006213 PEDRAZA Assigned Date: 9/4/2003 <br /> Program/Element Code 1600-FOOD PROGRAM <br /> Complainant: : MELINDA SANCHEZ-PHS NURSE Nome Phone <br /> Address Work Phone <br /> Nature of complaint. <br /> CHILD ILL WITH CAMPYLOBACTER AFTER EATING CHEESE PURCHASED FROM VENDOR IN FRONT OF K-MART ON MARIPOSA RD. NO <br /> AVAILABLE INFO ON TIME(S)OR DAY(S)OF WEEK CHEESE IS SOLD. <br /> Complaint Mode: A Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> PROPERTY INFORMATION _ PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner <br /> Site Location 2180 E MARIPOSA RP/DBA <br /> STOCKTON,CA RPAddress <br /> Billing Address <br /> i <br /> Home Phone <br /> Phone Work Phone <br /> District Location Code <br /> APN <br /> Date Abated q�Lo _ !2 Inspector: <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date. <br /> { <br /> Complaint Status Code: oe <br /> 1 <br /> I <br /> Circle appropriate Status Code { <br /> f <br /> 01 -FIELD ABATED 14-ENFORCEMENT CASE-Transferred to ER FILE <br /> 02-OFFICE ABATED 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# J <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 /> 06-EHD PERMIT FACILITY-see Linked PREMISE FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCY 213.FOODBORNE ILLNESS-Unconfirmed <br /> 08-UNABLE TO VERIFY 29-FOODBORNE ILLNESS-Confirmed <br /> I <br /> 09-FOODBORNE ILLNESS 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 54-LEAD HAZ DUST EVALUSATISFACTORI�LS-� <br /> o Cz <br /> 1 <br /> 5104.rpt <br />