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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00016595 Site Location: 2720 COUNTRY CLUB BLVD Account/D: AR0002070 <br /> Receivedby: EE0009157 BARCELLOS Received Date: 9/28/2001 <br /> Assigned To: EE0000418 KITH Assigned Date: 9/28/01 <br /> PromamrEtement Code: 1619-RETAIL MKT>1000 SO FT(MULTIPLE DEPTS) <br /> <br /> <br /> Nature of complaint: <br /> BOUGHT DOUGHNUTS AND FOUND DARK SPOTS IN DIFFERENT TYPES OF DOUGHNUTS. <br /> Complaint Mode P Complaint Mode Codes: A-Agency Referral B-Bd of Supemisors/Cily Council E-Code Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0002062-SAFEWAY MARKET&BAKERY#4159 Owner: OW0000429-SAFEWAY INC <br /> RP/DBA: <br /> Site Location: 2720 COUNTRY CLUB BLVD RPAddress: 47400 KATO RD <br /> STOCKTON,CA 95204 <br /> FREMONT,CA 94537 <br /> Mailing Address: PO BOX 29096 <br /> PHOENIX,AR 85038-9096 Billing Address:: PO BOX 29096 <br /> PHOENIX,AR 85038-9096 <br /> Phone:1st: 209-239-9327 Phone: Hm: 209-239-9327 <br /> Wk: 209-239-9327 � <br /> District 001 -GUTIERREZ,STEVE Location Code 99-UNINCORPORATED AREA <br /> APN completed <br /> Date Abated <br /> Inspector I F IAKpNY,, <br /> Send Referral to: <br /> Relenal Address: <br /> Referral Letter Sent by: <br /> Date: <br /> Complaint Status Code: <br /> 01-Field Abated 10-Substandard Property-See HOUSING ABATEMENT File <br /> 02-Office Abated 15-Active Housing Case-New Complaint See Active Case# <br /> 03-NAI Sent 16-Letter Sent To Tenant <br /> 04-Notice To Abate Issued 17-15-Day Letter Sent <br /> 05-Enforcement Action Initiated 50-Lead Hazard Evaluation Required(1) <br /> 06-EHD Permit Facility-See Linked Premise File 52-Lead Hazard Abatement in Progress(3) <br /> 07-Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory(4) <br /> 08-Invalid I Unable To Verify 51-Lead Hazard Work Plan Submitted(2) <br /> 09-Foodborne Illness 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> 11-Multiple Complaints-See Active Case# 55-Lead Hazard Monitoring Schedule(6) <br /> 12-Enforcement Case-Transferred To LIQUID WASTE File 56-Lead Hazard Abatement Complete(7) <br /> 13-Enforcement Case-Transferred To SOLID WASTE File 57-Lead Hazard Property Vacant W/Soil Contamination <br /> 14-Enforcement Case-Transferred To ER File 58-Lead Hazard Case-See Active File For This Site <br /> 0104.Mt <br />