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Complaint Investigation Form Report#:5104 <br /> COMP T D: C00026982 Site location: 20801 S WOODWARD AVE Account ID: AR0001050 <br /> Received y: EE0003600 BLACKWELL Received pate: 9/11/2007 Print Date: 9/11/2007 2:46:15PM <br /> Assigned 0: EE0001699 YOAKUM Assigned pate: 9/11/2007 SCA�L <br /> 1600-FOOD PROGRAM U <br /> Complainant.' :ANONYMOUS Home Phone <br /> Address Work Phone , <br /> Nature of cmpWnt <br /> FTATED HE OBSERVED THE BARTENDER,EMPLOYEE$,AND PATRONS SMOKING INSIDE THE BAR ABOUT TWO WEEKS AGO. <br /> Complaint MOde• P Complaint Made Codes AAWscy Referral B-Bd of Supervisors i City Council C-Counter <br /> ----- _ — ——— —_ — <br /> E-Code EnforcementM-Mail 1 Correspondence O-Other EH Unit -- <br /> P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0001052-ISLANDER TAVERN Owner: OW0000632-LIOTARD,JEFFREY LEO&TEVANI <br /> Ska Locaflon 20801 S WOODWARD AVE RP/DBA <br /> MANTECA.CA 95336 RP Address 1230 HIGTON ST <br /> MANTECA,CA 95336 <br /> Melling Address: PO BOX 1203 Billing Address 1230 HIGTON ST <br /> FRENCH CAMP,CA 95231-1203 MANTECA,CA 95336 <br /> Home Phone :209-825-4331 <br /> Phone :209-923-6019 Work Phone :209-629-3921 <br /> Oft& 005-ORNELLAS,LEROY Location Cade 99-UNINCORPORATED AREA <br /> APN 24125033 <br /> Dete Abated (q.D Inspector sly <br /> f-------------------------------------------------- <br /> Send Refenal to RW&ml Letter Sent by <br /> Referral Addrass Date: <br /> Complaint Status Code q <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 /> P-PNFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> OB- HD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> -REFERRED TO OTHER AGENCY 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> 08-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed 1 No Major Violations <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Major VkHatkxw IdentlHed <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 30-15 Day Letter Sent-Confimred Complaint Coinpleirlt H- <br /> 11-Multiple Complairris-SEE ACTIVE CASE# 31-15 Day Letter Sent-Alleged Complaint IstoAttached But Hp <br /> 12-ENFORCEMENT CASE-Transkmed to LIQUID WASTE FILE 50-LEAD HAZ EVALUATION REQUIRED(1) Scanned <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> t� <br /> completed <br /> 51 W.rpl <br />