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PW Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: COOU48810 Site Location: 5420 PACIFIC AVE Account ID: AR0024926 <br /> Received by: EE0009830 SAUERS Received Date: 2/11/2019 Print Date: 2/11/2019 3:25:56PM <br /> Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date: 2/11/2019 <br /> Pr <br /> Home Phone 209-625-8789 <br /> Address Work Phone <br /> E-Mail Address <br /> Nature of complaint: <br /> COMPLAINANT ALLEGEDLY GOT SICK WHILE CONSUMING TUSCAN SPINACH SOUP FROM THIS FACILITY.COMPLAINANT FELT QUEASY, <br /> COMPLAINANT CALLED THE FOLLOWING DAY AND EMPLOYEES SAID THE WATERY CONSISTENCY OF HER SOUP WAS NOT NORMAL. <br /> COMPLAINANT REQUESTED TO SPEAK TO A MANAGER BUT WAS TOLD HE WAS BUSY BUT THAT MANAGER SAID THAT SHE SHOULD CALL <br /> POISON CONTROL IF SHE BEGINS TO FEEL WORSE. <br /> `PLEASE CALL COMPLAINANT WITH FINDINGS <br /> Complaint Mode: P Complaint Mode 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-Internet/Email S-Sheriffs Office <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Facility: FA0014657-ROVIANOS MACARONI GRILL RP DBA <br /> Site Location 5420 PACIFIC AVE RP mailing address <br /> STOCKTON,CA 95207 <br /> Cross Street PACIFIC <br /> Mailing address 1855 BLAKE ST STE 200 RP contact <br /> DENVER,CO 80202-428 RP contact phone <br /> Phone 209-951-7064 EXT: <br /> Owner: OW0015906-MAC ACQUISITION LLC <br /> DBA <br /> Owner address 6750 LBJ FREEWAY <br /> DALLAS,TX 75240 <br /> Billing Address 3100 S GESSNER SUITE 125 <br /> HOUSTON,TX 77063 <br /> Home Phone 866-997-4777 <br /> Work Phone 832-649-2260 EXT: <br /> District 002-MILLER,KATHERINE Location Code <br /> APN 10224023 <br /> Date Abated Z-13-19 Inspector ID#: -F1 b h Z <br /> ---------- ---------------------------------------- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: 'X <br /> Circle appropriate Status Code <br /> 01 -Field Response-Violations Cited and Corrected 29-Alleged FBI-Major Violations Identified <br /> 02-Office Response Only 50-LEAD Assessment Performed-No Abatement Required <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 52-LEAD Abatement Reqired-See Program Record File <br /> 07-Referred to Other Agency 97-Disaster Planning and Response <br /> 08-Unable to Verify Alleged Complaint 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File MN-EHD Monitoring Status <br /> 11-Multiple Complaints-SEE ACTIVE CASE# PD-Permit Issued-Pending Well Installation <br /> 12-DA Referred Complaint-See Program Enforcement Action Form RS-Resolved-New Well Installed <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S1-Tank pumped <br /> Alleged FBI-No Major Violations Identified S2-Hooked up to public sewer <br /> omp amt Reviewed by: ate: pate y: i ate: I i <br /> 5104.rpt <br />