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UPJ <br /> Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00051555 Site Location: 3223 E HAMMER LN Account ID: AR0041475 <br /> Received by: EE0000014 MORENO Received Date: 2/4/2020 Print Date: 2/4/2020 12:35:14PM <br /> Assigned To: EE0078788 FAHMY Assigned Date: 2/4/2020 <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 /> ROACHES IN THE COOKING AREA. ROACHES IN THE RESTROOM. DUST MITES, ETC, 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 /> I-Internet/Email S-Sheriffs Office <br /> ------------------------------------------- -- - -- - – <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Facility:FA0022657-WALMART#1554 RP DBA <br /> Site Location 3223 E HAMMER LN RP mailing address <br /> STOCKTON,CA 95212 <br /> Cross Street HOLMAN <br /> Mailing address 508 SW EIGHTH ST DEPT 8916 RP contact <br /> BENTONVILLE,AR 72716--050 RP contact phone <br /> Phone 209-473-2796 <br /> Owner: OW0000596-Walmart Inc. <br /> DBA <br /> Owneraddress 702 SW EIGHTH ST <br /> BENTONVILLE,AR 72716-0500 <br /> Billing Address 702 Southwest 8th Street <br /> Bentonville,AR 72716--050 <br /> Home Phone 479-204-0140 <br /> Work Phone 479-204-3911 EXT: <br /> District 003-PATTI,TOM Location Code 01 -STOCKTON <br /> APN 12618006 // <br /> Date Abated a Inspector ID#: p /1 r 5 Cl)—el,i2- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: 68 <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 /> 0� 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 /> 28-Alleged FBI-No Major Violations Identified S2-Hooked up to public sewer <br /> omp aint Reviewed by:— I 2 ate: pate y: G.���/ � A ate: <br /> 5104.rpt ` `� <br />