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CO0040285
Environmental Health - Public
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1600 - Food Program
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CO0040285
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Entry Properties
Last modified
9/4/2020 4:53:16 PM
Creation date
2/11/2019 10:30:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0040285
PE
1600
FACILITY_ID
FA0018045
FACILITY_NAME
L & L HAWAIIAN B-B-Q
STREET_NUMBER
4555
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11017001
ENTERED_DATE
8/31/2015 12:00:00 AM
SITE_LOCATION
4555 N PERSHING AVE
RECEIVED_DATE
8/28/2015 12:00:00 AM
P_DISTRICT
002
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\P\PERSHING\4555\CO0040285.PDF
Tags
EHD - Public
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�1m Complaint Investigation Form Report M 5104 <br /> COMPLAINT ID: C00040285 Site Location: 4555 N PERSHING AVE Account ID.' AR0031738 <br /> Receivedby EE0005642 HENRY Received Date: 8/28/2015 Print Date: 8/31/2015 8:45:39AM <br /> Assigned To: EE0003361 FLOHRSCHUTZ Assigned Date: 8/31/2015 <br /> Proaram/Element Code:1600-FOOD PROGRAM <br /> Complainant :STOCKTON FIRE DEPT Home Phone <br /> Address Work Phone <br /> -Mail <br /> Address <br /> Nature of complaint: <br /> FIRE IN THE RESTAURANT KITCHEN. <br /> Complaint Mode: p Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> I-Intemet/Email S-Sherifrs Office <br /> - ----------------- ------ <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0018045-L&L HAWAIIAN B-B-Q Owner O WOO14819-LL ALOHA INC <br /> Site Location 4555 N PERSHING AVE STE 33A RPIDBA L&L HAWAIIAN B-B-Q <br /> STOCKTON,CA 95207 RP Address 1604 PARKWAY DR <br /> Gross;Sheet FOLSOM,CA 95630 <br /> Mailing Address: 4555 N PERSHING AVE STE 33A Billing Address 1604 PARKWAY DR <br /> STOCKTON,CA 95207 FOLSOM,CA 95630 <br /> Home Phone :916-458-2773 <br /> Phone :209478-0500 Work Phone :209-078-0500 <br /> District 002-MILLER,KATHERINE Location Code <br /> APN 1101700 <br /> Date Abated I Inspector ID#: � AiGR <br /> Send Referral to Referral Letter Sent by <br /> ReferralAddress Date: <br /> Complaint Status Code:61 <br /> Circle appropriate Status Code <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> Ot: IELD ABATED 28-FOODBORNE ILLNESS-No Major Violations Identified <br /> OFFICE ABATED 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 03-NAI SENT 50-LEAD Assessment Performed-No Abatement Required <br /> 04-NOTICE TO ABATE ISSUED 52-LEAD Abatement Regired-See Program Record File <br /> 05-DA-ENFORCEMENT ACTION INITIATED 97-Disaster Planning and Response <br /> OB-EHD FACILITY-see Linked PROGRAM FACILITY FILE 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 07-REFERRED TO OTHER AGENCY CL-Case Closed <br /> 08-UNABLE TO VERIFY <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File <br /> 11-Multiple Complaints-SEE ACTIVE CASE# <br /> 12-DA Referred Complaint-See Violation Tracking Form <br /> ompaml Reviewed by: I at 31 Updated y: ate: <br /> 5104 rpt <br />
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