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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00045743 Site Location: 4105 N WILSON WAY AccountlD: AR0034956 <br /> Receivedby.: EE0000040 JIMENEZ Received Date: 10/1/1991 Print Date: 2/72018 2:39:32PM <br /> Assigned To: EE0000753 NG Assigned Date: 2!7/2018 <br /> ProoramrElement Code:1600-FOOD PROGRAM <br /> Complainant: :JEFF&TRACY COULSON Home Phone : 209-833-0652 <br /> Address : 1480 CYPRESS CT Work Phone <br /> TRACY,CA 95376 E-Mail Address <br /> Nature ofcom laint: <br /> THIS COMPLAINT WAS FOUND IN FILING CABIN ET AND ALLEGES"ON 9/28/91,ATE THREE HOT DOGS EACH.4 HOURS LATER JEFF BECAME <br /> NAUSEATED.2 HOURS LATER VOMITING&DIARRHEA.TRACY BECAME ILL ABOUT 8 HOURS LATER WITH SAME SYMPTOMS. BOTH ILL FOR <br /> TWO DAYS." ORIGINAL CO#911778 DATED 10/01/1991 (GIVING]TAN ENVISION COMPLAINT#TO HAVE IN DATABASE FOR FUTURE <br /> REFERENCE.) <br /> Complaint Mode: P Complaint Motle Codes 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-Sheriff's Office <br /> ___________________________________________________________________________________________ ____________ __________________________________________- <br /> PROPERTY INFORMATION OWNER INFORMATION <br /> Facility:FA0019628-NEW STOCKTON 99 SPEEDWAY Owner: OW0016091-NOCETI GROUP INC <br /> Site Location 4105 N WILSON WAY RPIDBA <br /> STOCKTON,CA 95205 RPAddress PO BOX 340 <br /> Cress 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 002-MILLER,KATHERINE Location Code 99-UNINCORPORATED AREA <br /> APN 13202014 1 <br /> Date Abated t .01. ` Inspector ID#: N <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: D <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Connected 50-LEAD Assessment Performed-No Abatement Required <br /> G6ffice Response Only 52-LEAD Abatement Reqired-See Program Record File <br /> -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 Action Form St-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 /> omplaint Hevieweay: ate:Z eir,, Updated y: <br /> 5104.rpt <br />