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+ Complaint lnvestiga#ion Form <br /> COMPLA! T!D: C00035176 Site Location: 6717 P!_YMQUTH RD Report#:5104 <br /> Received by: EE0009058 LOWE Account ID: AR0004734 <br /> Received Date: 7/9/2012 <br /> Assigned To: EE00089$7 SANGALANG <br /> Assigned Date: 7/9/2012 Pnnt Date: 7/9/2012 11:58:53AM <br /> Prooram/Element Cade 2400-HOTEL/MOTEL PROGRAM <br /> Complainant: :ANON <br /> Address Nome Phone <br /> Work Phone <br /> -Mai!Address <br /> Nature of com lain t: <br /> (C}STATES SON WAS BITTEN BY BED BUGS.ROOMS 201-203.THEY STAYED IN THESE ROOMS FOR THE PAST 2-3 WEEKS. <br /> Complaint Mode: p Complaint Mode Codes A-Agency Referral <br /> B-Bd of Supervisors!City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit <br /> P-Phone <br /> 1-Internet!Email S-Sheriffs Office <br /> FACILITY INFORMATION <br /> OWNER INFORMATION <br /> Facility:FA0002506-MOTEL 6#1323 Owner; OW0001911 -BREVIA INN&RESTAURANT LLC <br /> Site Location 6717 PLYMOUTH RD RP/DBA <br /> BREVIA 1NN&RESTAURANT <br /> STOCKTON,CA 95207 RP Address 2099 N FORTUNE DR 500 <br /> Cross Street PLYMOUTH SAN JOSE,CA 95131 <br /> Mailing Address: PO BOX 117508 Billing Address 1625 FRENCH CAMP/TURNPIKE RD <br /> CARROLTON,TX 75011 STOCKTON,CA 95206 <br /> Home Phone :408.922-6886 <br /> Phone :209-951-8120 Work Phone ;20¢938-0999 <br /> District 002-RUHSTALLER,LARRY Location Code 99-UNINCORPORATED AREA <br /> APN 09760002 / <br /> Date Abated 7 Z Inspector 1D <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date. <br /> Complaint Status Code: D <br /> Circle appropriate Status Cade <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 0'1- IELD ABATED 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 0OFFICE ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 03-NAI SENT 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 04-NOTICE TO ABATE ISSUED 50-LEAD Assessment Performed-No Abatement Required <br /> 05-DA-ENFORCEMENT ACTION INITIATED 52-LEAD Abatement Reqired-See Program Record File <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> 07-REFERRED TO OTHER AGENCY 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08-UNABLE TO VERIFY CL-Case Closed <br /> 10-POSTED SUBSTANDARDIUNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 5144,rpt <br />