Laserfiche WebLink
Complaint Investigation Form Report M 5104 <br /> COMPLAINT ID: C00021822 Site Location: 678 N WILSON WAY Account ID: AR0004645 <br /> Received by: EE0006519 DISA Received Date: 11/22/2004 Print Date:11/22/2004 2:52:01PM <br /> Assigned To: EE0003027 N6IJW-SN �� z Assigned Date: 11/22/2004 <br /> Proram/Efement Code 1600-FOOD PROGRAM <br /> Complainant. : <br /> <br /> Nature of complaint: <br /> FRIDAY 11-19-04 FOUND A COCKROACH IN GROCERY BAG,THEN SUNDAY 11-21-04 PICKED UP BAG OF ORANGE'S THERE WERE SEVERAL <br /> COCKROACH'S UNDER IT. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> --------- ------—————------------------------------ <br /> FACILITY <br /> -----------------------------FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0002463-FOOD 4 LESS Owner: OW0001562-PAQ INC <br /> Site Location 678 N WILSON WAY RP/DBA : <br /> STOCKTON,CA 95205 RP Address 3341 WILLOWBROOK CR <br /> STOCKTON,CA 95219 <br /> Mailing Address: 8014 LOWER SACRAMENTO RD#1 Billing Address 17935 MURPHY PARKWAY <br /> STOCKTON,CA 95210 LATHROP,CA 95330 <br /> Home Phone <br /> I Phone :209-957-4917 Work Phone - <br /> District Location Code 01 -STOCKTON <br /> APN <br /> ---Date Abated 124—1 1 f� ---------Inspector. --- ------- <br /> Send Referral to 1 l Referral Letter Sent 4y <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 28-FOODBORNE ILLNESS-Unconfirmed <br /> 08-UNABLE TO VERIFY 29-FOODBORNE ILLNESS-Confirmed ERTEREQ <br /> 09-FOODBORNE ILLNESS 50-LEAD HAZ EVALUATION REQUIRED(1) L T <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 11-Multi Ie Complaints-SEE ACTIVE CASE# 52-LEAD HAZ ABATEMENT IN PROGRESS 3) <br /> p p ( <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 54-LEAD HAZ DUST EVALUATION SATISFACTORY(5) <br /> Complaint History <br /> Imaged By Attached But Not - <br /> Scaanzled <br /> 5104.rpt <br /> f <br />