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Complaint Investigation Form <br /> p g Report#:5104 <br /> COMPLAINT ID: C00052270 Site Location: 121 S CENTER ST Account ID: AR0047544 <br /> Received by: EE0006213 PEDRAZA Received Date: 7/15/2020 Print Date: 7/15/2020 11:39:44AM <br /> Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date: 7/15/2020 <br /> Program/Element Code 1600-FOOD PROGRAM <br /> Complainant: <br /> Home Phone <br /> E-Mail Address <br /> Nature of complaint: <br /> COMPLAINANT ALLEGES THAT THE EMPLOYEES PREPARING FOOD ARE NOT FOOD SAFETY CERTIFIED. THE CONTAINERS USED TO <br /> PREPARE THE FOOD ARE NOT PROPERLY WASHED. THE RESTROOMS ARE FILTHY,GLOVES ARE NOT BEING USED PROPERLY, <br /> WORKERS ARE NOT WEARING HAIR RESTRAINTS PROPERLY. <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:FA0025268-7 ELEVEN 38153A RP DBA <br /> Site Location 121 S CENTER ST RP mailing address <br /> STOCKTON,CA 95202 <br /> Cross Street MARKET <br /> Mailing address PO BOX 219088 RP contact <br /> DALLAS,TX 75221 RP contact phone <br /> Phone 209-361-8332 <br /> Owner: OW0023940-BSHARPS INC <br /> DBA 7 ELEVEN 38153A <br /> Owneraddress 5453 CONSUMNES DR <br /> STOCKTON,CA 95219 <br /> Billing Address PO BOX 219088 <br /> DALLAS,TX 75221 <br /> Home Phone 209-518-3496 <br /> Work Phone <br /> District 001 -VILLAPUDUA,MIGUEL Location Code 01-STOCKTON <br /> APN 13730016 �1 / I�, <br /> Date Abated `��—� �—v Inspector ID#: -Ft O Y I Y S GI� -z- <br /> ------------------------------------------------- <br /> Send <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: R 1 O <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 /> 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 aintReviewed2y ate: p ated y: ate: <br /> 5104.rpt V // <br />