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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00045083 Site Location: 1756 N WILSON WAY Account ID. : <br /> Receivedby: EE0000035 HERNANDEZ Received Date: 5/23/1991 Print Date2/152018 9:14:30AM <br /> Assigned To: EE0000753 NG Assigned Date: 11/912017 <br /> Program/Element Code'1600-FOOD PROGRAM <br /> Complainant: :RENEE MELTON-STATE FOOD AND DRUG Home Phone : 209-948-7716 <br /> Address Work Phone <br /> -Mail Address <br /> Nature of complaint; <br /> COMPLAINT WAS FOUND AND ALL "ON 5122/91 COMPLAINANT PURCHASED A 1 LB LOAF OF BRAND WHITE BREAD.BREAD SMELLED <br /> LIKE MILDEW.THIS HAS HAPPENED BEFORE WITH OTHER FOODS AT THIS MARKET.MANAGEMENT HAS BEEN RUDE WHEN QUESTIONED. <br /> TV BRANDS ARE OWNED BY FLEMMING FOOD CO.OKLAHOMA CITY OK 73126"ORIGINAL COMPLAINT#910743 ON 5/23/91.(GIVEN <br /> ENVISION COMPLAINT NUMBER TO HAVE IN DATA BASE FOR FUTURE REFERENCE) <br /> Complaint Mode: P Complaint Motle Cotles A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> I-Intemet/Email S-Sheriffs Office <br /> —— <br /> -----—————————————————————————————————————— <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner:DAISY BOGUE <br /> Site Location 1756 N WILSON RP/DBA MY MINI MART <br /> STOCKTON,CA 95205 RP Address <br /> Cross Street <br /> Billing Address <br /> Home Phone 209-461-4831 <br /> Phone Work Phone209-941-2264 <br /> District 001-V ILLAPUDUA,CARLOS Location Code 01-STOCKTON <br /> APN 11721005 , 1 <br /> Date Abated J D ' 'I 1 Inspector ID#: N GI <br /> ----------------------------- <br /> Send Referral to <br /> Referral Letter Sent by <br /> Date: <br /> Re/emal Address <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> 01- laid Response-Violations Cited and Corrected 50-LEAD Assessment Performed-No Abatement Required <br /> 2-Office Response Only 52-LEAD Abatement Regired-See Program Record File <br /> o6-Violations Cited-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> 07-Refferred to Other Agency 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08-Unable to Verify Alleged Complaint 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# RS-Resolved-New Well Installed <br /> 12-DA Referred Complaint-See Program Enforcement Aclion Form S1-Tank pumped <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S2-Hooked up to public sewer <br /> 28-Alleged FBI-No Major Violations Identified S3-Septic system repaired <br /> 29-Alleged FBI-Major Violations Identified <br /> ate: t Pate y: '� ;)/_ <br /> omp aint eviewe y: }��5• aFl <br /> 5104.ryr <br />