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4a -' <br /> Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00031260 Site Location: 3 S PACIFIC AVE Account ID: AR0000912 <br /> Received by: EE0007541 FIELD <br /> Received Date: 11/19/2009 Print Date: 11/19/2009 2:49:30PM <br /> Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date: 1111912009 <br /> Program/Element Code:1600-FOOD PROGRAM <br /> Complainant: :ANONYMOUS Nome Phone ; <br /> Address Work Phone <br /> E-Mail Address <br /> Nature of complaint. <br /> THERE ARE RATS IN THE STOCKROOM OF THE CAFETERIA. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors I City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail l Correspondence O-Other EH Unit P-Phone <br /> --------- -- ----- -- ----------- ----- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0000915-LODI USD-LORI HIGH SCHOOL Owner: OW0000031 -LODI UNIFIED SCHOOL DISTRICT <br /> Site Location 3 S PACIFIC AVE RP/DBA LODI UNIFIED SCHOOL DISTRICT <br /> LODI,CA 95242 RP Address 1305 E VINE ST <br /> Cross Street PACIFIC LODI,CA 95240 <br /> Mailing Address: 1305 E VINE ST Billing Address 1305 E VINE ST <br /> LODI,CA 95240 LODL CA 95240 <br /> Nome Phone <br /> Phone Work Phone <br /> District 004-VOGEL,KEN Location Code 02-LODI <br /> APN 03511012 <br /> Date Abated Inspector., -- <br /> ------------------------------ - -----------1� - <br /> - <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: e O <br /> Circle appropriate Status Co <br /> 1 - IELD ABATED 50-LEAD Assessment Performed-No Abatement Required <br /> 02-OFFICE ABATED 52-LEAD Abatement RegiredSee Program Record File <br /> 03-NAI SENT 97-Disaster Planning and Response <br /> 04-NOTICE TO ABATE ISSUED 99-UNSPECIFIED-Old Complaint-No Original Found-Pre-tracking <br /> O6 HD FACILITY-see Linked PROGRAM FACILITY FILE CL-Case Closed <br /> 07-REFERRED TO OTHER AGENCY <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARDIUNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> lf 12-DA Referred Complaint-See Violation Tracking Form <br /> I 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> fj 28-FOODBORNE ELLNESS-No Major Violations Identified <br /> 29-FOODBORNE ILLNESS-Major Violations Identified <br /> i <br /> 514 t <br />