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Complaint Investigation Form Report#:5104 <br /> a <br /> COMPLAINT ID: 000018993 Site Location: 875 S TRACY BLVD Account ID: AR0012224 <br /> Received by: EE0002282 RABACA Received Date: 5/9/2003 Print Date: 5/9/2003 3:36:51 PM <br /> Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date: 5/9/2003 <br /> Program/Element Code:1619-RETAIL MKT>1000 SQ FT(=1>2 DEPTS) I <br /> Complainant: :ANONYMOUS Home Phone <br /> Address Work Phone ; <br /> Nature of complaint <br /> IN DELI DEPT,THERE IS A CEILING TILE THAT IS VERY MOLDY, FOOD IS PERPARED UNDER THIS TILE,COMPLAINANT TOLD MANAGER 3 <br /> WEEKS AGO,NOTHING DONE. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors t City Council C-Counter <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone i <br /> ------ ------------------------------------ <br /> FACILITY <br /> - ---- ---- --- ---- -- I <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0007582-ALBERTSONS#7295 Owner: OW0006258-LUCKY STORES INC <br /> Site Location 875 S TRACY BLVD RPIDBA ALBERTSON'S <br /> TRACY,CA 95376 RP Address PO BOX 20 <br /> BOISE,ID 83726 <br /> Mailing Address: PO BOX 20 Billing Address PO BOX 20 <br /> BOISE,ID 83706 BOISE.,ID 83706 <br /> Home Phone :208-895-6785 <br /> Phone :209-830-1980 Work Phone <br /> District 005-ORNELLAS,LEROY Location Code 03-TRACY <br /> APN <br /> Date Abated �,� Inspector: ( <br /> -_-- ---- ----.-._. L --P- -- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code, <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 /> 05-ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> 06-EHD PERMIT FACILITY-see Linked PREMISE FILE 28-FOODBORNE ILLNESS-Unconfirmed <br /> 07-REFERRED TO OTHER AGENCY 29-FOODBORNE ILLNESS-Confirmed <br /> 08-UNABLE TO VERIFY 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 09-FOODBORNE ILLNESS 51 -LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 54-LEAD HAZ DUST EVALUATION SATISFACTORY(5) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 55-LEAD HAZ MONITORING SCHED(6) <br /> i <br /> 5104.rpt <br />