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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00016088 Site Location: 5308 PACIFIC AVE Account ID: AR0002467 <br /> Received by: EE0006519 DISA Received Date: 6/13/2001 <br /> Assigned To: EE0000321 OLIVEIRA Assigned Date: 6/13/01 <br /> Procram/E/ement Code: 1625-RESTAURANT/BAR 51-100 SEATS <br /> Complainant: <br /> <br /> Nature of complaint: <br /> 06-09-01 IN THE AFTERNOON ATE CHEESEBURGER AND YOGURT.LATER ON STOMACH FELT BAD,DID NOT EAT ANYTHING MORE. <br /> SUNDAY BEGAN VOMITING HAD DIARRHEA,CRAMPS,AND SLIGHT FEVER.STILL HAS DIARRHEA. DOCTOR SAID FOOD POISONING. <br /> Complaint Mode P Complaint Mode Codes: A-Agency Referral B-Bd of Supervisors/City Council E-Code Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0002906-MCOONALDS#11159 Owner: OW0000446-SCHRADER, DON <br /> RP/DBA: MCDONALDS <br /> Sife location: 5308 PACIFIC AVE RPAddress: 4502 GEORGETOWN PL 202 <br /> STOCKTON,CA 95207 <br /> STOCKTON,CA 95207 <br /> Mailing Address: 4502 GEORGETOWN PL STE 202 <br /> STOCKTON,CA 95207 Billing Address:: 4502 GEORGETOWN PL#202 <br /> STOCKTON,CA 95207 <br /> Phone:1st: 209-957-5223 Phone: <br /> Wk: 209-478-0234 <br /> District 002-MARENCO,DARIO Location Code 01 -STOCKTON <br /> APN <br /> Date Abated 6/t'{ lot <br /> Inspector <:J <br /> Send Referral to: <br /> Referral Address: <br /> Referral Letter Sent by: <br /> Date: <br /> Complaint Status Code: <br /> 01-Field Abated 10-Substandard Property-See HOUSING ABATEMENT File <br /> 02-Office Abated 15-Active Housing Case-New Complaint Sae 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 50-Lead Hazard Evaluation Required(1) <br /> 06-EHD Permit Facility-See Linked Premise File 52-Lead Hazard Abatement in Progress(3) <br /> 07-Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) <br /> Invalid/Unable To Verify 51 -Lead Hazard Work Plan Submitted(2) <br /> 09 Foodbome Illness 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> Multiple Complaints-See Active Case# 55-Lead Hazard Monitoring Schedule(6) <br /> 12-Enforcement Case-Transferred To LIQUID WASTE File 56-Lead Hazard Abatement Complete(7) <br /> 13-Enforcement Case-Transferred To SOLID WASTE File 57-Lead Hazard Property Vacant W/Soil Contamination <br /> 14-Enforcement Case-Transferred To ER File 58-Lead Hazard Case-See Active File For This Site <br /> 0104 mt <br />