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r <br /> " — Complaint Investigation Form <br /> COMPLAINT ID: C00046455 Report 5104 <br /> Site Location: 25456 S SCHULTE RD Account ID. AR0037529 <br /> Receivedby: EE0004589 LINHARES <br /> 9 EE0004589 LINHARES Received Date: 4/24/2018 Print Date: 4/24/2018 4:32:13PM <br /> Assi ned To.' <br /> Assigned Date: 4/24/2018 <br /> Pmoram,EI ment de 1600-FOOD PROGRAM <br /> Complainant: :CATHY <br /> Address Home Phone : 209.879-1900 <br /> Work Phone <br /> -Mail Address <br /> Nature ofcom saint: <br /> TAQUERICHAS CHICKEN BLOOD ON THE FLOOR,THE ODOR FROM THE RESTAURANT COMES INTO FACILITY NEXT DOOR.SPOILED <br /> FOOD.MICE/ RATS <br /> Complaint Mode: In Complaint Mode Codes A-Agency Referral <br /> B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mall/Correspondence O-Other EH Unit <br /> P-Phone <br /> --------- - _ I-Internet/Email S-Sheriffs Office <br /> PROPERTY INFORMATION <br /> - ----------------- - - -- - - <br /> - -- - - -- --------------------------------------------------- <br /> OWNER INFORMATION <br /> Facility:FA0020888-JALOS TAQUERIA <br /> Site Location Owner: OW0017179-REYNOSQ HUGO ALBERTO <br /> 25456 S SCHULTE RD RPrDBq <br /> Cross Street TRACY,CA 95377 RPAddress 196 CARNATION CIR <br /> Mailing Address: 25456 S SCHULTE RD VALLEJO,CA 94589 <br /> TRACY,CA 95377 Billing Address 196 CARNATION CIR <br /> VALLEJO,CA 94589 <br /> Phone :209-830-8066 Home Phone ;707-333-2175 <br /> Work Phone 209-830-8066 <br /> District 005-ELLIOTT,BOB <br /> Location Code <br /> APN 20944035 99-UNINCORPORATED AREA <br /> Date Abated li—"Z--r 1 Inspector to#: <br /> ------------------------------ �n�a�/PiL <br /> ----------------------------- <br /> Send Referral to <br /> Releffa/Address Referral Letter Sent by <br /> Date: <br /> Complaint Status Code: \ <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Corrected 50-LEAD Assessment Pedormad-No Abatement Required <br /> 02-Office Response Only 52-LEAD Abatement Regired-See Program Record File <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE <br /> 97-Disaster Planning and Response <br /> 07-Reffemed to Other Agency 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08-Unable to Verify Alleged Complaint <br /> MN-EHD Monitoring Status <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File PD-Permit issued-Pending Well Installation <br /> 11-Multiple Complaints-SEE ACTIVE CASE# Ca Old`1b 4s' <br /> 12-DA Referred Complaint-See Program Enforcement Action Form .3 Sl --Tank <br /> p Resolved-New Well Installed <br /> 51 pumped <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> S2-Hooked up to public sewer <br /> 28-Alleged FBI-No Major Violations Identified <br /> S3-Septic system repaired <br /> 29-Alleged FBI-Major Violations Identified <br /> ompamt Remewe y: _ ate: <br /> Y Date: <br /> e V J <br /> 5104.mt l r P a 0 <br />