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Complaint Investigation Form Report#:5104 <br /> COMPLAINT D. C00026471 Site Location: 4555 N PERSHING AVE STE 21 Account ID: AR0004721 <br /> Received by: 0007541 FIELD Received Date: 6/11/2007 Print Date: 6/11/2007 3:14:21PM <br /> Assigned To: EE 00149 BORGES Assigned Date: 6/11/2007 <br /> Proararn/Element Code 1600-FOOD PROGRAM <br /> Complainant: :HOWARD KARNEY Nome Phone : 209-988-5532 _1 <br /> Address Work Phone ; <br /> Nature of complaint., <br /> ABOUT 2:55 PM ON 6111107, (C)WENT INTO FACILITY AND OBSERVED THE COUNTER TO BE SITCKY AND FILTHY. FEMAILE EMPLOYEE <br /> WAS HANDLING MONEY AND SERVING FOOD WITHOUT GLOVES OR WASHING HER HANDS. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors l City Council C-Counter <br /> E-Code Enforcement M-Mail l Correspondence O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0002515-AE VINCIS DELICATESSEN Owner: OW0001922-CMD PARTNERSHIP <br /> Site Location 4555 N PERSHING AVE STE 21 RP/DBA DE VINCIS DELICATESSEN <br /> STOCKTON,CA 95207 RP Address 909 OAKLEAF WAY <br /> STOCKTON,CA 95209 <br /> Mailing Address: 909 OAKLEAF WAY Billing Address 909 OAKLEAF WAY <br /> STOCKTON,CA 95209 STOCKTON,CA 95209 <br /> Home Phone :209-403-7898 <br /> Phone :209-957-2750 Work Phone :209-957-2750 <br /> District 002-RUHSTALLER,LARRY Location Code 01 -STOCKTON <br /> APN 11017001 <br /> Date Abated ] Inspector. <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: ©� <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 /> 06-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 1 No Major Violations <br /> 29-FOODBORNE ILLNESS-Major Violations Identified�0mr1 dint 1415tOty <br /> 09-FOODBORNE ILLNESS Attached But Not <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 30-15 Day Letter Sent-Confirmed CDmplaint <br /> 31-15 Da Letter Sent-Alleged Complaint <br /> SCansled <br /> 11-Multiple Complaints-SEE ACTIVE CASE# y 9 P <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> C1 '2 <br /> 5104.rpt <br />