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c W Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00052581 Site Location: 1601 S LOWER SACRAMENTO RD Account ID: AR0043411 <br /> Rece,4ved by: EE0009830 SAUERS Received Date: 9/8/2020 Print Date: 9/8/2020 9:47:26AM <br /> Assigned To: EE0001084 RAMIREZ Assigned Date: 9/8/2020 <br /> Proaram/Element Code 1600-FOOD PROGRAM <br /> Complainant: <br /> <br /> E-Mail Address <br /> Nature of complaint: <br /> COMPLAINANT PURCHASED A LOAF OF WONDER BREAD FROM THIS FACILITY ON 9/4/2020.COMPLAINANT ALLEGES THAT WHEN THEY <br /> WENT TO USE IT ON 9/5/2020,THERE WERE MULTIPLE MAGGOTS CRAWLING AROUND INSIDE OF THE BAG.COMPLAINANT HAD NOT <br /> OPENED IT BEFORE 9/5/2020.COMPLAINANT SPOKE WITH MANAGER,AND ALLEGES MANAGER DID NOT SEEM TO CARE. <br /> —PLEASE CALL COMPLAINANT WITH FINDINGS. <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:FA0023528-WALMART#1789 RP DBA <br /> Site Location 1601 S LOWER SACRAMENTO RD RP mailing address <br /> LODI,CA 95242 <br /> Cross Street KETTLEMAN <br /> Mailing address 508 SW EIGHTH ST DEPT 8916 RP contact <br /> BENTONVILLE,AR 72716--050 RP contact phone <br /> Phone 209-368-6696 <br /> Owner: OW0021809-WAL-MART <br /> DBA WALMART <br /> Owner address 702 SW EIGHTH ST <br /> BENTONVILLE,AR 72716--050 <br /> Billing Address 508 SW EIGHTH ST DEPT 8916 <br /> BENTONVILLE,AR 72716--050 <br /> Home Phone 209-368-6696 <br /> Work Phone <br /> District 004-WINN,CHARLES Location Code 02-LODI <br /> APN 05803012 <br /> Date Abated q' /L( l-uzv Inspector ID#: V <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: (� <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 /> 0-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 Progra/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: pate by: ate: C100/40 <br /> 5104,rpt <br />