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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00016602 Site Location: 224 W KETTLEMAN LN Account ID: AR0000723 <br /> Receivedby: EE0000099 Frost Received Date: 9/28/2001 <br /> Assigned To: EE0000467 CARRUESCO Assigned Date: 10/1/01 <br /> PmomMElement Code: 1625-RESTAURANT/BAR 51-100 SEATS <br /> <br /> <br /> Nature of complaint: <br /> 09-20-01 HUSBAND ATE CHICKEN AND GOT SICK VOMITTING AND HAD DIARRHEA. <br /> Complaint Mode P Complaint Mode Codes: A-Agency Referral B-Bd of Supervisors/City Council E-Code Enforcement <br /> M-Mail/Correspondence O-Other EH Unit C-Counter P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0000724-KENTUCKY FRIED CHICKEN#120 Owner: OW0006092-HARMAN-DAVE&LISA INC <br /> RP/DBA: KENTUCKY FRIED CHICKEN#120 <br /> Site Location: 224 W KETTLEMAN LN RPAddress: 5544 S GREEN ST <br /> LODI,CA 95240 <br /> MURRAY,UT 84123-5798 <br /> Mailing Address: 5544 S GREEN ST <br /> MURRAY,UT 84123-5798 MURRAY,Billing Address:: S GREEN ST <br /> 41 <br /> MURUT 84123-5798 <br /> Phone:1st: 415-727-0163 <br /> Phone: <br /> Wk: 801-486-2300 <br /> District 004-SEIGLOCK,JACK Location Code 02-LODI <br /> APN <br /> Date Abated <br /> Inspector <br /> Send Referral to: <br /> Referral Address: <br /> Referral Letter Sent by.. <br /> Date: <br /> Complaint Status Code: 0 <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/Unable To Verify 51-Lead Huard Work Plan Submitted(2) <br /> 09-Foodbome 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.rpt <br />