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A I - Y <br /> '1v,-\V/`},/a % Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00051982 Site Location: 300 W KETTLEMAN LN Account ID: AR0000914 <br /> Received by: EE0000014 MORENO Received Date: 5/20/2020 Print Date: 5/20/2020 9:55:0IAM <br /> Assigned To: EE0001084 RAMIREZ Assigned Date: 5/20/2020 <br /> Program/Element Code 1600-FOOD PROGRAM <br /> <br /> <br /> <br /> Nature of complaint: <br /> STORE IS REALLY DIRTY,STORE SMELLS VERY BAD, IT'S VERY CROWDED,NOT FOLLOWING SOCIAL DISTANCING GUIDELINES. <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:FA0000917-99 Cents Only Stores#157 RP DBA <br /> Site Location 300 W Kettleman Ln RP mailing address <br /> Lodi,CA 95240 <br /> Cross Street HUTCHINS <br /> Mailing address 4000 Union Pacific Avenue RP contact <br /> Commerce,CA 90023 RP contact phone <br /> Phone 209-339-9103 EXT: <br /> Owner: OW0010964-99 Cents Only Stores <br /> DBA <br /> Owneraddress 4000 UNION PACIFIC AVE <br /> COMMERCE,CA 90023 <br /> Billing Address 4000 Union Pacific Avenue <br /> Commerce,CA 90023 <br /> Home Phone 323-980-8145 <br /> Work Phone 323-980-8145 EXT: <br /> District 004-WINN,CJES Location Code 02-LODI <br /> APN 06202005 <br /> Date Abated I .J�t� 2V Inspector ID#: P-0 pvt.1 ✓4 L' <br /> -------------- ---------------------------------- -- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Coder <br /> Circle appropriate Status Code <br /> 0 ield 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 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: ate: p ated 1 <br /> 5104.rpt L <br />