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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00045065 Site Location: 678 N WILSON WAY Account ID. <br /> Received by: EE0000035 HERNANDEZ Received Date: 2/19/1991 Print Date: 11/8/2017 1:56:17PM <br /> Assigned To: EE0000753 NG Assigned Date: 11/8/2017 <br /> PreOram,Element CodeA 600-FOOD PROGRAM <br /> Complainant: : <br /> <br /> <br /> Nature ofcomplaint., <br /> COMPLAINT WAS FOUND AND ALLEGES"DAUGHTER ATE A CHICKEN DINNER AND WAS ALRIGHT UNTIL 5AM THIS MORNING.SHE WAS <br /> HEAVING AND CRAMPING REALLY BAD,ALSO HAD DIARRHEA SYMPTOMS.HER FEVER WAS ABOUT 100 DEGREES AND WAS GIVEN <br /> MEDICATION'ORIGINAL COMPLAINT#910188 ON 2/19/91.(GIVEN ENVISION COMPLAINT NUMBER TO HAVE IN DATA BASE FOR FUTURE <br /> 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/Comespondence O-Other EH Unit P-Phone <br /> ]-Internet/Email S-Sherifrs Office <br /> ------------------------------------------------- <br /> PROPERTY INFORMATION PROPERTY OWNER INFORMATION <br /> Property Name: Responsible Party or Property Owner:EL POLLO LOCO <br /> Site Location 678 N WILSON RP/DBA EL POLLO LOCO <br /> STOCKTON,CA 95205 RPAddress <br /> Cross Street <br /> Billing Address <br /> Home Phone <br /> Phone Work Phone <br /> District 001-VILLAPUDUA,CARLOS Location Code 01-STOCKTON <br /> APN 14129005 <br /> Date Abated ',)—, A\ Inspector ID#: N <br /> --------------——————————————————————————————————— <br /> Send Referral to Referral Letter Sent by <br /> Referal Address Date: <br /> Complaint Status Code: 06 <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Corrected 50-LEAD Assessment Performed-No Abatement Required <br /> Office Response Only 52-LEAD Abatement Regired-See Program Record File <br /> V06- iolalions Cited-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> Reffemed 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# 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 /> ompalnt Reviewed by: ate: pate y: ate: <br /> 5104.rpt <br />