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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00046309 Site Location: 2211 N WILSON WAY Account ID: AR0007526 <br /> ` Receivedby: EE0000040 JIMENEZ Received Date: 4/13/2018 <br /> Print Date: 4/13/2018 4:5I:35PM <br /> Assigned7o: EE0078788 FAHMY <br /> Assignetl Date: 4/13/2018 <br /> ProoramrElemenl Code:1600-FOOD PROGRAM <br /> Complainant: Complainant Not Specified <br /> Home Phone <br /> Address <br /> Work Phone <br /> -Mail Address envy. pwa i agmal.com <br /> Nature of complaint: <br /> COMPLAINANT SAW COCKROACH WALKING ON COUNTER ON 4/12/1 BAT 6:00 PM.OWNER WAS MADE AWARE. <br /> Complaint Mode: I Complaint Mode Codes A-Agent Referral <br /> Y B-13d of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence 0-Other EH Unit P-Phone <br /> ---------------_---------------------_------------------------------------ <br /> PROPERTY INFORMATION I-Intemet/Email S-Sheriffs ORos <br /> -------------------OWNER INFO RMATION------------------------------------------------------ <br /> Facility:FA0001527-FAR EAST RESTAURANT <br /> Owner: OW0001191 -HUANG,CHUNYUAN <br /> Site Location 2211 N WILSON WAY RP/DBA FAR EAST RESTAURANT <br /> STOCKTON,CA 95205 RPAddress 2329 CHAMBERLAIN ST <br /> Cross Street WILSON STOCKTON,CA 95212 <br /> Mailing Address: 2329 CHAMBERLAIN ST Billing Address 2329 CHAMBERLAIN ST <br /> STOCKTON,CA 95212 STOCKTON,CA 95212 <br /> Home Phone ;209-623-9612 <br /> Phone :209-4634478 Work Phone :209-4634478 <br /> District 002-MILLER,KATHERINE Location Code 01-STOCKTON <br /> APM 11707050 <br /> Date Abated n _ til I Inspector lD <br /> Send Re/erral to <br /> Referral Adtlress Referral Letter Sent by <br /> Date: <br /> Complaint Status Code: .F-1 <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Corrected 50-LEAD Assessment Performed-No Abatement Required <br /> 02-Office Response Only 52-LEAD Abatement Reqired-See Program Record File <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> 07-Referred 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 Action Form 81-Tank pumped <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S2-Hooked up to public sewer <br /> 28-Allegetl FBI-No Major Violations Identified 83-Septic system repaired <br /> 29-Allegetl FBI-Major Uolations Identified <br /> ompamt Reviewed b 31 _ <br /> ate: <br /> 5104.rpt 'k I P ata y: a � / ✓ <br />