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ou! Complaint Investigation Form Report # : 5104 <br /> COMPLAINT ID : C00050316 Site Location : 7707 S AUSTIN RD Account ID: AR0043039 <br /> Received by: EE0000467 CARRUESCO Received Date: 8/13/2019 Print Date: 8/ 13/2019 2 : 52 :27PM <br /> Assigned To: EE0009832 ACEVEDO Assigned Date: 8/13/2019 <br /> Program/Element Code 1600 - FOOD PROGRAM <br /> Complainant: <br /> <br /> <br /> Nature of complaint: <br /> FOOD SERVICE PROVIDER AT CHCF IS MAKING FOOD FROM HOME AND SERVING IT TO PATIENTS . THE FOOD IS GETTING <br /> COMPLAINANT'S CHILD ILL. <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-Sheriff's Office <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Facility : FA0023367 - HUDSON FOODS - CHCF RP DBA <br /> Site Location 7707 AUSTIN RD RP mailing address <br /> STOCKTON, CA 95215 <br /> Cross Street ARCH <br /> Mailing address PO BOX 4518 RP contact <br /> STOCKTON, CA 95204 RP contact phone <br /> Phone 209-244-5828 <br /> Owner: OW0021593 - HUDSON-MENDOZA, DENISE L <br /> DBA HUDSON FOODS <br /> Owner address 3012 RIVERSIDE CT <br /> STOCKTON, CA 95204 <br /> Billing Address PO BOX 4518 <br /> STOCKTON, CA 95204 <br /> Home Phone 209-244 -5828 <br /> Work Phone <br /> District 001 - VILLAPUDUA, MIGUEL Location Code 99 - UNINCORPORATED AREA <br /> APN 18115013 /� <br /> Date Abated I Inspector ID #: ( (�V Ce <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> 01 - Field Response-Violations Cited and Corrected 29 - Alleged FBI - Major Violations Identified <br /> 02 - Office Response Only D L 50 - LEAD Assessment Performed- No Abatement Required <br /> 06 - Violations Cited - see Linked PROGRAM FACILITY FILE <br /> ` 'mac 52 - LEAD Abatement Reqired-See Program Record File <br /> U0 - Referred to Other Agency `/ S � 97 - Disaster Planning and Response <br /> 08 - Unable to Verify Alleged Complaint 0 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 /> w <br /> omplaint Reviewed by@ Date: pate y: Da e` : F <br /> ! Lig, <br /> 5104. rpt <br />