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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00049834 Site Location: 864 W CHARTER WY Account ID: AR0005087 <br /> Received by: EE0009830 SAUERS Received Date: 5/20/2019 Print Date: 5/20/2019 3:54:06PM <br /> Assigned To: EE0004589 LINHARES Assigned Date: 5/20/2019 <br /> Prooram/Elemenf Code 1600-FOOD PROGRAM <br /> <br /> <br /> <br /> Nature of complaint: <br /> COMPLAINANT ALLEGES THERE ARE ROACHES IN THE DINING AREA AND THE FOOD PREP AREA.PLEASE CALL COMPLAINANT. <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-Intemet/Email S-Sheriffs Office <br /> ------------------------------------------------- <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Facility:FA0004680-TACO BELL#18799 RP DBA <br /> Site Location 864 W CHARTER WAY RP mailing address <br /> STOCKTON,CA 95206 <br /> Cross Street CHARTER <br /> Mailing address 4709 MANGELS BLVD RP contact <br /> FAIRFIELD,CA 94534-417 RP contact phone <br /> Phone 209-946-0970 EXT: <br /> Owner: OW0001707-PRB Management,LLC <br /> DBA TACO BELL <br /> Owner address 4709 MANGELS BLVD <br /> FAIRFIELD,CA 94534-4175 <br /> Billing Address 4709 MANGELS BLVD <br /> FAIRFIELD,CA 94534-417 <br /> Home Phone 707-864-2919 <br /> Work Phone 707-864-2919 EXT: <br /> District 001-VILLAPUDUA,MIGUEL Location Code 01-STOCKTON <br /> APN 16323048 <br /> Date Abated , _2 2—1 Inspector ID#: r\V-)c-,(xf� <br /> --------------------------------------------------- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: GQ) <br /> Circle appropriate Status Code v <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 Verity 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 /> 28-Alleged FBI-No Major Violations Identified S2-Hooked up to public sewer <br /> omp aint Reviewed by: Date: Updated by: ate: <br /> 51Q4.rpt�\ <br />