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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00052438 Site Location: 3223 E HAMMER LN Account ID: AR0041475 <br /> Received by: EE0000467 CARRUESCO Received Date: 8/12/2020 Print Date: 8/12/2020 4:52:23PM <br /> Assigned To: EE0007380 SHIH Assigned Date: 8/12/2020 <br /> Program/Element Code 1600-FOOD PROGRAM <br /> Complainant: <br /> <br /> E-Mail Address <br /> Nature of complaint: <br /> DELI DEPARTMENT PROVIDES PLASTIC FORKS,SPOONS,AND KNIVES THAT ARE NOT IN PLASTIC. THEY ARE IN THE OPEN. <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 � Zh Inspector ID#: <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code:61 <br /> Circle appropriate Status Code <br /> 01- 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 /> omplaint Reviewed y: ate: updated by: ate: I <br /> 5104.rpt 4 <br /> fit/ <br />