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" ilr Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00040373 Site Location: 4855 HWY 99 E FRONTAGE Account ID:-AR001 2179 <br /> Receivedby: EE0000028 ALI Received Date: 9/15/2015 Print Date: 9/15/2015 9:09:03AM <br /> Assigned To: EE0008999 HUYNH Assigned Date: 9/15/2015 <br /> Prooram/Element Code:1600-FOOD PROGRAM <br /> Complainant: ; <br /> <br /> <br /> Nature of complaint: <br /> COMPLAINANT STATES WASHROOM HAS NO WASH SINK,NO HANDLE ON THE DOOR AND NO SOAP.VERY UNSANITARY. PLEASE CALL <br /> COMPLAINANT WITH FINDINGS. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> I-Intemet t Email S-Sheriffs Office <br /> ------------------------------- ----------------- <br /> .-- --------------- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0007571-ARCH ARCO AM PM* Owner: OW0014804-EAGE INVESTMENTS LLC <br /> Site Location 4855 S HWY 99 EAST FRONTAGE RD RP/DBA <br /> STOCKTON,CA 95215 RP Address 2755 FAIROAKS RD <br /> Cross Street ARCH RD TRACY,CA 95304 <br /> Mailing Address: 4855 S HWY 99 EAST FRONTAGE RD Billing Address 8657 RANCH RD, <br /> STOCKTON,CA 95215 TRACY,CA 95304 <br /> Home Phone :209-830-0102 <br /> Phone :209-948-2438 EXT: work Phone :209-948-2438 EXT: <br /> Distract 001-VILLAPUDUA,CARLOS Location Code ; <br /> APN 17926051 <br /> Date Abated Ca /(V1 Inspector 1D#: ii+V�q n ! <br /> ------------------------------------------------- <br /> Send <br /> ----------------- -_._ -__._.__ ---__-.-----_-_-._------------------- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: d�(J <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 01-FIELD ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 02-OFFICE ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 03-NAI SENT 50-LEAD Assessment Performed-No Abatement Required <br /> 04-NOTICE TO ABATE ISSUED 52-LEAD Abatement Reqired-See Program Record File <br /> 05-DA-ENFORCEMENT ACTION INITIATED 97-Disaster Planning and Response <br /> 05-EHD FACILITY-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-REFERRED TO OTHER AGENCY CL-Case Closed <br /> 08-UNABLE TO VERIFY MN-EHD Monitoring Status <br /> PD-Permit Issued-Pending Well Installation <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File RS-Resolved-New Well Installed <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> omp aint Reviewed by: ate: Updated by: ate: <br /> 51c4.rpt I <br /> 1 <br />