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i <br /> Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00036963 Site Location: 4510 ALITALIA AVE Account 1D: AR0020219 <br /> Roceivedby: EE0090753 MARTINEZ Received Date: 9/10/2013 Print Date: 9/10/2013 2:27:35PM <br /> Assigned To: EE0006213 PEDRAZA Assigned Date: 9110/2013 <br /> Program/Element Code:1600-FOOD PROGRAM <br /> Complainant: : <br /> <br /> <br /> Nature of complaint: <br /> EVIDENTS OF RODENTS IN THIS FACILITY. (C)SAW/SEES FECES,TEETH MARKS ON BOTTLE, PACKAGES,AND THE SMELL OF DEATH <br /> ODORS <br /> Complaint Mode: I Complaint Mode Codes A-Agency Referral B-Bd of Supervisors I City Council C-Counter F-Fax <br /> trtr E-Code Enforcement M-Mail f Correspondence O-Other EH Unit P-Phone <br /> Yf———__——I-Internet!Email _ S-Sheriffs Office <br /> 111 FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0012365-STAPLES Owner: OW0006371 -STAPLES THE OFFICE SUPERSTORE <br /> I Site Location 4510 ALITALIA AVE RP/DBA <br /> STOCKTON,CA 95206 RPAddress 500 STAPLES DR <br /> Cross Street FRAMINGHAM,MA 01702 <br /> Mailing Address: 4510 ALITALIA AVE#300 v Billing Address 500 STAPLES DR <br /> STOCKTON,CA 95206 FRAMINGHAM,MA 01702 <br /> Home Phone ;508-253-5438 <br /> r <br /> �iPhone ;209-234-2195 EXT: 0 Work Phone <br /> District' ; Location Code <br /> APN 11113039 <br /> Date Abated r Inspector ID 71' <br /> Send Referral to U Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> 01-FIELD ABATED 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 02-OFFICE ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> 03-NAI SENT 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 04-NOTICE TO ABATE ISSUED 50-LEAD Assessment Performed-No Abatement Required J <br /> { 05-DA-ENFORCEMENT ACTION INITIATED 52-LEAD Abatement Reqired-See Program Record Fi}e �- <br /> 06-EHD FACILITY-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> 07-REFERRED TO OTHER AGENCY 99-UNSPECIFIED-Old Complaint-No Original Found <br /> I <br /> 08.UNABLE TO VERIFY CL-Case Closed <br /> 1 10-POSTED SUBSTANDARDIUNSECURED-See Housing File ) LL <br /> 4 11 -Multiple Complaints-SEE ACTIVE CASE# <br /> 1 � <br /> 4 <br /> "k- <br /> 5104 rpt <br />