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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00034610 Site Location: 415 E OREGON ST Account to: AR0000744 <br /> Receivedby EE0009058 LOWE Received Date: 2/8/2012 Print Date: 2/8/2012 2:11:15PM <br /> Assigned To: EE0003474 OM Assigned Date: 2/8/2012 <br /> ProommrElement Code_1600-FOOD PROGRAM <br /> Complainant: :TERESA Home Phone 209-253-0084 <br /> Address <br /> - Work Phone <br /> E-Mail Address <br /> Nature of complaint. <br /> (CI ALLEGES THE RESTROOMS ARE SO DIRTY THAT HER SON REFUSES TO USE THE BATHROOM AND COMES HOME AFTER SCHOOL <br /> WITH A STOMACH ACHE, <br /> Complaint Mode. p Complain!Mode Codes A-Agency Referral B-Bd of Supervisors I City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> 1-Internet I Email S-Sheriffs Office <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0000745-RIPON LSU-RIPONA SCHOOL Owner. OW0000548-RIPON UNIFIED SCHOOL DIST <br /> Site Location 415 E OREGON ST RP/DBA <br /> RIPON,CA 95366 RP Address 304 N ACACIA AVE <br /> Cross Street OREGON RIPON,CA 95366 <br /> Mailing Address: 304 NACACIA Billing Address 304 N ACACIA AVE <br /> RIPON,CA 95366 RIPON,CA 95366 <br /> Home Phone :209-599.2131 <br /> Phone :209-599-2131 Work Phone <br /> District 005-ORNELLAS,LEROY Location Code 05-RIPON <br /> APN 26118018 <br /> Date Abated Z - -7 — 2 Inspector ID#. 3 r-� 7 <br /> Send Referral to Referral Letter Sent by <br /> Re/emal Address <br /> Date: <br /> Complaint Status Code: r1 <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 02-OFFICE ABATED 50-LEAD Assessment Performed-No Abatement Required <br /> 03-NAI SENT 52-LEAD Abatement Raqired-See Program Record File <br /> 04-NOTICE TO ABATE ISSUED 97-Disaster Planning and Response <br /> 05-DA-ENFORCEMENT ACTION INITIATED 99-UNSPECIFIED-Old Complaint-No Original Found <br /> -9 EHD FACILITY-see Unked PROGRAM FACILITY FILE CL-Case Closed <br /> 07-REFERRED TO OTHER AGENCY <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE If <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 5104.rpt <br />