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r. <br /> Complaint Investigation Form Report#:5104 <br /> — f <br /> COMPLAINT ID: C00050148 Site Location: 4219 E WATERLOO RD Account ID: <br /> Received by: EE0009819 BENIAMINE Received Date: 7/17/2019 Print Date: 7/17/2019 3:03:01PM <br /> Assigned To: EE0009819 BENIAMINE Assigned Date: 7/17/2019 <br /> Program/Element Code 1322-SUBSTANDARD HOUSING <br /> Complainant: <br /> <br /> <br /> Nature of complaint: <br /> BLOOD,COCKROACHES AND BED BUGS IN ROOM 163 AND ROOM 267. <br /> Complaint Mode: 1 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 /> -- ----------------- --------------- ------- - --- -- <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Property Name: RP DBA <br /> Site Location 4219 E WATERLOO RD RP mailing address <br /> STOCKTON,CA 95215 <br /> Cross Street 99 ON RAMP <br /> Mailing address RP contact <br /> RP contact phone <br /> Phone <br /> Property Owner:WATERLOO ENTERPRISES INC <br /> DBA <br /> Owner address <br /> Billing Address 4219 E WATERLOO RD <br /> STOCKTON,CA 95219 <br /> Home Phone <br /> Work Phone <br /> District 002-MILLER,KATHERINE Location Code 99-UNINCORPORATED AREA <br /> APN 08710009 <br /> Date Abated V16 Inspector ID#: f) /I1. a yYt k VN–JL— <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> �/ <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 Regired-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 S-Resolved-New Well Installed <br /> 9- <br /> 5 ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE#Fqz '"6ri -Tank pumped <br /> 28-Alleged FBI-No Major Violations Identified S2-Hooked up to public sewer <br /> omp aint Reviewed by: Date: 2 /q pate y: a <br /> 5104.rpt ` ` / <br />