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r =: Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00023641 Site Location: 4555 N PERSHING AVE 16 Account ID: AR0004707 <br /> Receivedby: EE0003600 BLACKWELL Received Date: 11/9/2005 Print Date.' 11/9/2005 2:35:33PM <br /> Assigned To: FE0000467 CARRUESCO Assigned Date: 1119!2005 <br /> { Program/Element Code:1600-FOOD PROGRAM <br /> Complainant: :ANONMOUS Home Phone 209-823-8044 <br /> Address Work Phone <br /> Nature of complaint., <br /> LEFT SIDE OF STORE IS UNCOVERED COOKED FOOD COVERED WITH FLIES. RIGHT SIDE IS UNCOOKED FISH COVERED WITH FLIES. <br /> Complaint Mode: P ComplaintMode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> ------------------------------------------------- <br /> FACILITY <br /> ---------- ------ <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0002514-ASIAN SUPERMARKET Owner: OW0001919-UNG,ALICIA <br /> Site Location 4555 N PERSHING AVE 16 RP/DBA ASIAN SUPERMARKET <br /> STOCKTON,CA 95207 RP Address 8667 MARINERS DR 467 <br /> STOCKTON,CA 95219 <br /> Mailing Address: 4555 N PERSHING 416 Billing Address 8667 MARINERS DR 467 <br /> STOCKTON,CA 95207 STOCKTON,CA 95219 <br /> Nome Phone ;209-952-3508 <br /> Phone :209-957-3097 Work Phone :209-957-3097 ^/tJ�fL,"n <br /> District-002-MAR£NCO,DARIO Location Code 01-STOCKTON �/�'� <br /> APN 11017001 <br /> Date Abated II_ k7 -0_5 Inspector- p <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint History <br /> Complaint Status Code: v 2v Attached But Not <br /> Scanned <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 14-ENFORCEMENT CASE-Transferred to ER 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 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> I_b5-EHD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCY 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> 08-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Confirmed <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 5104,rpt <br />