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Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: 000045399 Site Location: 678N WILSON WAY STE 37 AccountlD: AR0004676 <br /> Received by: EE0000025 SEDRA Received Date: 1/11/2018 Print Date: 1/11/2018 12:48:12PM <br /> Assigned Ta: EE0008999 HUYNH Assigned Date: 1/11/2018 <br /> PmcremiE/ement Code:1600-FOOD PROGRAM <br /> Complainant: : <br /> <br /> <br /> Nature of complaint: <br /> COMPLAINANT ALLEGES THEY WERE AT THE FACILITY ON 1/11/2017 AT APPROXIMATELY 12:20 PM.WHEN THEY REACHED FOR AN ITEM <br /> ON A SHELF 2 MICE RAN ACROSS THE SHELF. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Coda Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> I-Intemet/Email S-Sheriffs Office <br /> ------------------------------------------------- <br /> PROPERTY <br /> --- ---- ----- --_--_---_-------_---_--- _-- <br /> PROPERTY INFORMATION OWNER INFORMATION <br /> Facility:FA0002472-DOLLAR TREE#01240 Owner: OW0006662-Dollar Tree Stores,Inc. <br /> Site Location 678 N WILSON STE 37 RP/DBA <br /> STOCKTON,CA 95205 RPAddress 500 VOLVO PKWY <br /> Cross Street FREMONT CHESAPEAKE,VA 23320 <br /> Mailing Address: 500 Volvo Pkwy Billing Address 500 Volvo Parkway <br /> Chesapeake,VA 23320 Chesapeake,VA 23320 <br /> Home Phone :757-321-5000 <br /> Phone :209-547-9898 EXT: Work Phone 757-321-5000 EXT: <br /> District 001-VILLAPUDUA,CARLOS Location Code 01-STOCKTON <br /> APN 14129007 <br /> Date Abated 0!y I/1 Inspector ID#: VtXAII(1 <br /> ------------------------------------------------- <br /> Send — Sent by <br /> --------------_ <br /> toReferralL <br /> Send Referral <br /> Refsma/Address Date: <br /> Complaint Status Coder <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Corrected 50-LEAD Assessment Performed-No Abatement Required <br /> 02-Office Response Only 52-LEAD Abatement Regired-See Program Record File <br /> 06-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-SEE ACTIVE 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# 52-Hooked up to public sewer <br /> 28-Alleged FBI-No Major Violations Identified 53-Septic system repaired <br /> 29-Alleged FBI-Major Violations Identified <br /> ompamt Reviewed by:,—I,,., <br /> ate: pate <br /> .Z <br /> 5104.rpr <br />