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BL <br /> • Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00050182 Site Location: 608 E CHARTER WAY Account ID: AR0002295 <br /> Received by: EE0000014 MORENO Received Date: 7/23/2019 Print Date: 7/23/2019 4:29:5011M <br /> Assigned To: EE0009832 ACEVEDO Assigned Date: 7/23/2019 <br /> Program/Element Code 1600-FOOD PROGRAM <br /> Complainant: ANONYMOUS Home Phone <br /> Address Work Phone <br /> E-Mail Address <br /> Nature of complaint: <br /> ON 07/23/19 AT AROUND 12PM FAMILY WENT TO EAT AT FACILITY AND EVERYONE(FAMILY OF 4)GOT SICK FROM THE FOOD,SYMPTOMS <br /> INCLUDING STOMACH PAIN AND DIARRHEA. COMPLAINANT OBSERVED LOTS OF FLIES INSIDE FACILITYAND INSIDE OF RESTAURANT <br /> WAS REALLY DIRTY.PLEASE SEND INSPECTOR AS SOON AS POSSIBLE. <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 /> 1-Internet/Email S-Sheriff's Office <br /> -- -------------------------------------- <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Facility:FA0002283-BIRRIEVIA BETOS MEXICAN FOODS RP DBA <br /> Site Location 608 E CHARTER WAY RP mailing address <br /> STOCKTON,CA 95206 <br /> Cross Street AMERICAN <br /> Mailing address 608 E CHARTER WAY RP contact <br /> STOCKTON,CA 95206 RP contact phone <br /> Phone 209-460-1663 <br /> Owner: OW0006647-HERNANDEZ,JUAN J <br /> DBA <br /> Owner address 168 SEVENTH ST <br /> STOCKTON,CA 95206 <br /> Billing Address 168 SEVENTH ST <br /> STOCKTON,CA 95206 <br /> Home Phone 209-460-1663 EXT: CELL <br /> Work Phone 209-518-7300 <br /> District 001 -VILLAPUDUA,MIGUEL Location Code 01 -STOCKTON <br /> APN 16715049 <br /> Date Abated —+/-t \ i( n Inspector ID#: 111.�JVG� <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 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 /> IX <br /> 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 /> /28E Alleged FBI-No Major Violations Identified S2-Hooked up to public sewer <br /> omp aint Reviewed by::i ate: Updated by: ate: <br /> 5104.rpt <br /> S <br />