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Complaint Investigation Form Account IDAR0000792 Report*5104 <br /> COMPLAW ID: C00043802 Site Location: 1110 N. MAIN <br /> : <br /> Received by: EE0000467 CARRUESCO <br /> Received Date: 7/13/2017 Print Date: 7/13/2017 8:46:03AM <br /> Assigned To: EE0004589 LINHARES Assigned Date: 7/13/2017 <br /> Prooram/Element C-ode:1600-FOOD PROGRAM Home Phone : 209.471-2306 <br /> Complainant: :JESSIE <br /> Work Phone <br /> Address <br /> -Mail Address <br /> Nature of COM lain t: <br /> COMPLAINANT ATE ON 7/9/17 AROUND 9PM.OBSERVED FOOD EMPLOYEE USING A DIRTY WIPE CLOTH AND THEN REACH INTO <br /> REFRIGERATOR AND GRAB SHRIMP TO COOK WITHOUT WASHING HANDS.ALSO OBSERVED A BOWL OF RICE AT ROOM TEMPERATURE <br /> ON THE COOK LINE BEING SERVED TO CUSTOMERS. <br /> Complaint Mode: pA-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> Complaint Mode Codes <br /> E-Cade Enforcement M-Mall/Correspondence O-Other EH Unit P-Phone <br /> I-Intemet/Email S-Sheriffs Office <br /> PROPERTY INFORMATION <br /> OWNER INFORMATION <br /> Facility:FA0000794-TAQUERDI LA ESTRELLA Owner: OW0017389-FONSECA,JUAN F <br /> Site Location 1110 N MAIN ST RP/DBA : <br /> MANTECA,CA 95336 RPAddress <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> District 003-BESTOLARIDES,STEVE Location Code 01-STOCKTON <br /> APN 21821023 �I <br /> Date Abated ,-21— I Inspector lD#: ��.(��CA(es <br /> -------------- <br /> Referral Letter Sent by <br /> Send Referral to Date: <br /> Referral Address <br /> Complaint Status Code:01 <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 28-Alleged FBI-No Major Violations Identified <br /> 01-Field Response-Violations Cited and Corrected 29-Alleged FBI-Major Violations Identified <br /> 02-Office Response Only <br /> 50-LEAD Assessment Performed-No Abatement Required <br /> 52-LEAD Abatement Reqired-See Program Record File <br /> 97-Disaster Planning and Response <br /> Oa-Violations Cited-see Linked PROGRAM FACILITY FILE <br /> 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-Refferred to Other Agency <br /> MN-EHD Monitoring Status <br /> 08-Unable to Verify Alleged Complaint <br /> PD-Pennil issued-Pending Well Installation <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> RS-Resolved-New Well Installed <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Program Enforcement Action Form <br /> ompamt eviewe y:• ,l I <br /> ale: Pdate bY: ate: J <br /> 51(A.rpt 13 <br />