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CO0047852
Environmental Health - Public
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2400 - Hotel and Motel Program
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CO0047852
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Last modified
8/17/2020 7:42:01 AM
Creation date
3/8/2019 11:50:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2400 - Hotel and Motel Program
RECORD_ID
CO0047852
PE
2409
FACILITY_ID
FA0002187
STREET_NUMBER
4219
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
08710009
ENTERED_DATE
12/3/2018 12:00:00 AM
SITE_LOCATION
4219 E WATERLOO RD
RECEIVED_DATE
12/3/2018 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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ADMIN
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EHD - Public
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Complaint Investigation Form Report#:5104 <br /> COMFLiANT ID: C00047852 Site Location: 4219 E WATERLOO RD AccountlD. AR0002198 <br /> Received by: EE0000014 MORENO Received Date: 12/3/2018 Print Date. 12/3/2018 3:54:57PM <br /> Assigned To: EE0009819 BENIAMINE Assigned Date: 12/3/2018 <br /> <br /> ILSON Home Phone 405-657-9358 <br /> Address Work Phone <br /> E-Mail Address <br /> Nature of complaint: <br /> ON WEDNESDAY 11/28/18 COMPLAINANT STAYED IN ROOM#134,WOKE UP WITH BED BUGS ALL OVER HER BODY. <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 INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Facility:FA0002187- V G�/ S/� RP DBA <br /> Site Location 4219 E WATERLOO RD / RP mailing address <br /> STOCKTON,CA 95215 <br /> Cross Street H WY 99 <br /> Mailing address 4219 E WATERLOO RD Recontact <br /> STOCKTON,CA 95215 RP contact phone <br /> Phone 209-981-8116 <br /> Owner: OW0001699-WATERLOO ENTERPRISES INC <br /> DBA CLARION INN&SUITES <br /> Owner address 4219 E WATERLOO RD <br /> STOCKTON,CA 95215 <br /> Billing Address 4219 E WATERLOO RD <br /> STOCKTON,CA 95215 <br /> Home Phone 209-981-8116 <br /> Work Phone <br /> District 004-WINN,CHARLES Location Code 99-UNINCORPORATED AREA <br /> APN 08710009 �! <br /> Date Abated l/I rV( I Inspector ID#: � <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: O <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Corrected 29-Alleged FBI-Major Violations Identified <br /> 02-Office Response Only 50-LEAD Assessment Performed-No Abatement Required <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 52-LEAD Abatement Reqired-See Program Record File <br /> 07-Referred to Other Agency 97-Disaster Planning and Response <br /> 08 Unable to Verify Alleged Complaint 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File MN-EHD Monitoring Status <br /> 11-Multiple Complaints-SEE ACTIVE CASE# PD-Permit Issued-Pending Well Installation <br /> 12-DA Referred Complaint-See Program Enforcement Action Form RS-Resolved-New Well Installed <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S1-Tank pumped <br /> 28-Alleged FBI-No Major Violations Identified S2-Hooked up to public sewer <br /> omplaint Reviewedy: �a e:�.^ I p a e y: a AV I <br /> 5104.rpt d I <br />
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