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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00044147 Site Location: 678 N WILSON WAY Account ID: <br /> Receivedby.: EE0000035 HERNANDEZ Received Date: 5/14/1993 Print Date: 9/72017 8:33:12AM <br /> Assigned To: EE0000753 NG Assigned Date: 9/1/2017 <br /> ProoramrElement Code:1600-FOOD PROGRAM <br /> Complainant: : <br /> <br /> <br /> Nature ofcomplaint: <br /> COMPLAINT FOUND AND ALLEGES"ON 5/12/93 ATE LUNCH AND HAD A COMBINATION OF ALL FOOD.APPROXIMATELY 5PM BECAME ILL <br /> WITH DIARRHEAAND VOMITING,NO DOCTOR SEEN."ORIGINAL COMPLAINT#930760 ON 5/14/93.(GIVEN ENVISION COMPLAINT NUMBER <br /> TO HAVE IN DATABASE FOR FUTURE REFERENCE). <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-Internet/Email S-Sheriffs Office <br /> ----- --------------------------- - - - - - -------- ---- <br /> PROPERTY <br /> ---- ---_—_— ------------- _ - - - - _— —_ _--_PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name:GHINGGIS KHAN Responsible Party or Property Uwner GHINGGIS KHAN <br /> Site Location 678 N WILSON RP/DBA GHINGGIS KHAN <br /> STOCKTON,CA 95205 RPAddress <br /> Cross Street FREMONT <br /> Billing Address <br /> Home Phone 209-466-8899 <br /> Phone ; Work Phone <br /> District 001-VILLAPUDUA,CARLOS Location Code 01 -STOCKTON <br /> APN 14129024 <br /> Date Abated 5 -Lo- G�j Inspector ID#: <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: 01 <br /> Circle appropriate Status Code <br /> Co -Field Response-Violations Cited and Corrected 50-LEAD Assessment Performed-No Abatement Required <br /> 02-Office Response Only 52-LEAD Abatement Reqired-See Program Record File <br /> os-Violations Cited-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> 07-Refferred to Other Agency 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08-Unable to Verify Alleged Complaint MN-EHD Monitoring Status <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File PD-Permit Issued-Pending Well Installation <br /> 11-Multiple Complaints-SEEACTIVE CASE# RS-Resolved-New Well Installed <br /> 12-DA Referred Complaint-See Program Enforcement Action Form S1-Tank pumped <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S2-Hooked up to public sewer <br /> 28-Alleged FBI-No Major Violations Identified S3-Septic system repaired <br /> 29-Alleged FBI-Major Violations Identified <br /> ompaint Reviewed by: ate. Updatede <br /> 5104 rpt <br />