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Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00014412 Site Location: 20801 S WOODWARD AVE Account ID: AR0001050 <br /> Received by: EE0000001 TURKATTE Received Date: 7/6/2000 <br /> Assigned To: EE0003497 QUINLIN Assigned Date: 7/6100 <br /> Program/Element Code: 1625-RESTAURANT/BAR 51-100 SEATS <br /> Complainant: CITIZEN-ANON Home Phone: <br /> Address: Work Phone: <br /> Nature of complaint: <br /> BATHROOMS NEV CLEANED I NO PAPER TOWELS,FACILITY IS DIRTY <br /> Complaint Mode P Complaint Mode Codes A-Agency Refers B-Bd of Supervisors/Cit) C-Count( E-Code Enforcem( <br /> M-Mail/Corresponds O-Other EH Unit P-Phone <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility: FA0001052-ISLANDER TAVERN OW0000823-GOMES,CHERYL <br /> Site Location: 20801 S WOODWARD AVE DBA: ISLANDER TAVERN <br /> MANTECA,CA 95336 RP Address: 1141 WILLIAMSON RD <br /> Mailing Address: 20801 S WOODWARD <br /> MANTECA,CA 95336 Billing Address: 1141 WILLIAMSON <br /> Phone: 1st: 209-823-3767 MANTECA,CA 95336 <br /> Phone: Hm: 209-823-3767 <br /> Wk: <br /> District: 005-CABRAL, ROBERT Location Code: 04-MANTECA <br /> APN: <br /> Date Abated: <br /> Inspector —2 i1�I ciL�l1 <br /> Send Referral to: <br /> Referral Letter Sent by: <br /> Referral Address: Date: <br /> Complaint Status Code: <br /> 01 -Field Abated 10-Substandard Property-See HOUSING ABATEMENT 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 50-Lead Hazard Evaluation Required(1) <br /> 06-EHD Permit Facility-See Linked Premise File 52-Lead Hazard Abatement in Progress(3) <br /> 07-Referred To Other Agency 53-Lead Hazard Visual Inspect Satisfactory (4) <br /> 8 Invalid/Unable To Verify 51 -Lead Hazard Work Plan Submitted(2) <br /> - Foodborne Illness 54-Lead Hazard Dust Evaluation Satisfactory(5) <br /> 11 -Multiple Complaints-See Active Case# 55- Lead Hazard Monitoring Schedule (6) <br /> 12- Enforcement Case-Transferred To LIQUID WASTE File 56- Lead Hazard Abatement Complete (7) <br /> 13- Enforcement Case-Transferred To SOLID WASTE File 57- Lead Hazard Property Vacant W/Soil Contamination <br /> 14- Enforcement Case-Transferred To ER File 58- Lead Hazard Case-See Active File For This Site <br /> 0104.rpt <br />