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K Complaint Investi ation Form <br /> 9 Report#:5104 <br /> (,OMPL HINT ID: C00036321 Site Location: 4105 N WILSON WAY Account 1D: AR0034956 <br /> Receivedby: EE0090753 MARTINEZ Received Date: 4/25/2013 Print Date: 4/25/2013 9:39:05AM <br /> Assigned To: EE0001084 RAMIREZ Assigned Date: 4/25/2013 <br /> Pmoram0omentCode,1600-FOOD PROGRAM <br /> Complainant: :TONYA Home Phone 775-741-8000 <br /> Address <br /> ' Work Phone <br /> -Mall Address <br /> Nature of complaint: <br /> BATHROOMS ARE VERY DIRTY.THE CO-ED BATHROOM IS THE SAME AS THE MENS BATHROOM. <br /> Complaint Mode: p Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> — 1-InternetI Email S-Sheriff's Office <br /> FACILITY INFORMATION OWNER INFORMATION - <br /> Faciiity:FA0019628-NEW STOCKTON 99 SPEEDWAY Owner: OW0016091 -NOCETI GROUP INC <br /> Site Location 4105 N WILSON WAY RP/DBA - <br /> STOCKTON,CA 95205 RP Address PO BOX 340 <br /> Cross Street FRENCH CAMP,CA 95231 <br /> Mailing Address: PO BOX 340 Billing Address PO BOX 340 <br /> FRENCH CAMP,CA 95231 FRENCH CAMP,CA 95231 <br /> Home Phone ;209-466-9999 <br /> Phone :209-466-9999 Work Phone :209-482-6969 <br /> District Location Code <br /> APN <br /> Date Abated Inspector ID <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: fi 1 n <br /> Circle appropriate Status Code l U <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 01-FIELD ABATED 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 02-OFFICE ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 03-NAI SENT 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 04-NOTICE TO ABATE ISSUED 50-LEAD Assessment Performed-No Abatement Required <br /> 05-DA-ENFORCEMENT ACTION INITIATED 52-LEAD Abatement Reqired-See Program Record File <br /> 05 <br /> A61`EHD FACILITY-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> 1077-REFERRED TO OTHER AGENCY 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08-UNABLE TO VERIFY CL-Case Closed <br /> 10-POSTED SUBSTANDARDIUNSECU RED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 51a4.rpt <br />