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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00016539 Site Location: 2005 N TRACY BLVD Account ID: AR0002548 <br /> Received by: EE0009157 BARCELLOS Received Date: 9/17/2001 COMETS Assigned To: EE0000418 KITH Assigned Date: 9/17/01 ��I'lL- <br /> Program/Element Code: /W-_FOOD FOOD PROGRAM <br /> Complainant: <br /> <br /> Nature of complaint: <br /> A PATIENT A 9 AWL RAW OYSTERS ON 09-04-01 AT 6 PM AND HAD DIARRHEA ON 09-06-01. VIBRO PARAHEMOLYTICAS HAS BEEN <br /> CONFIRMED. <br /> Complaint Mode P Complaint Made 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: FA0002986-SAVE MART SUPERMARKETS#15 Owner: OW0002227-SAVE MART SUPERMARKETS <br /> RP/DBA: <br /> Site Location: 2005 TRACY BLVD RP Address: PO BOX 4278 <br /> TRACY,CA 95376 MODESTO,CA 95352 <br /> Mailing Address: PO BOX 4278 <br /> Billing Address:: PO BOX 4278 <br /> MODESTO,CA 95352 MODESTO,CA 95352 <br /> Phone:1st: 209-577-1600 Phone: <br /> Wk: 209-577-1600 <br /> District 005-BEDFORD,LYNN Location Code 03-TRACY <br /> APN <br /> Date Abated V l <br /> Inspector <br /> Send Referral to: <br /> Referral Address: <br /> Referral Letter Sent by. <br /> Date: j <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 See 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-EHO 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 /> 08-Invalid/Unable To Verify 51 -Lead Hazard Work Plan Submitted(2) <br /> 09-Foodborne Illness 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> 11-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 /> o1o4.rpt <br />