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Complaint Investigation Form Report#:5104 <br /> AOMPLAINT ID: C00021358 Site Location: 4104 SECTION AVE Account to: AR0002144 <br /> Received by: EE0008844 ABATE Received Date: 8/1912004 Print Date: 8120!2004 3:56:05PM <br /> Assigned To: EE0001699 YOAKUM Assigned Date: 8/19/2004 <br /> Program/Element Code 1600-FOOD PROGRAM <br /> Complainant: ; <br /> <br /> Nature of complaint. <br /> (C)HAS PURCHASED HOT POCKETS AT THE MARKET ON MORE THAN ONE OCCASION AND THE HOT POCKETS HAVE BEEN MOLDY. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter ! <br /> i <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> — <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0002134-WOODYS BI RITE MARKET Owner: OW0001660-NGUYEN,VANG THI <br /> Site Location 4104 SECTION AVE RP/DBA WOODYS BI RITE MARKET <br /> STOCKTON,CA 95215 RPAddress 2027 ROSEMARIE LN 169 <br /> STOCKTON,CA 95207 <br /> Mailing Address: 4104 SECTION AVE Billing Address 2027 ROSEMARIE LN 169 <br /> STOCKTON,CA 95215 STOCKTON,CA 95207 <br /> Home Phone :209-952-3391 <br /> Phone :209-463-2037 Work Phone :209-463-2037 <br /> District 002-MARENCO,DARIO Location Code 99-UNINCORPORATED AREA <br /> APN 17318101 r <br /> Date Abated � z3�a� Inspector. <br /> -------------------- ------------------------------ <br /> Send <br /> ------- ------ ----- -------- <br /> Send Referral to Referral Letter Sent by <br /> i <br /> Referral Address Date: <br /> i <br /> Complaint Status Codeo_( j <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 14-ENFORCEMENT CASE-Transferred to ER FILE <br /> 02-OFFICE ABATED 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 03-NAI SENT 16-LETTER SENT TO TENANT <br /> 04-NOTICE TO ABATE ISSUED 17-15 DAY LETTER SENT <br /> o5-ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> /�-EHD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> v07-REFERRED TO OTHER AGENCY 28-FOODBORNE ILLNESS-Unconfirmed <br /> 08-UNABLE TO VERIFY 29-FOODBORNE ILLNESS-Confirmed <br /> 09-FOODBORNE ILLNESS 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 54-LEAD HAZ DUST EVALUATION SATISFACTORY(5) <br /> C0 jgpL NTDESK <br /> COPY <br /> i <br /> 5104.rpt _ ! <br />