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V J <br /> Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00051837 Site Location: 678 N WILSON WAY STE 3 Account ID: AR0004629 <br /> Received by: EE0000467 CARRUESCO Received Date: 4/7/2020 Print Date: 4/7/2020 12:21:47PM <br /> Assigned To: EE0009832 ACEVEDO Assigned Date: 4/7/2020 <br /> Proaram/Element Code 1600-FOOD PROGRAM <br /> Complainant: <br /> Home Phone <br /> E-Mail Address <br /> Nature of complaint: <br /> IMPROPER FOOD HANDLING,HAND WASHING,AND FOOD PREP. <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:FA0002462-EL POLLO LOCO#3307 RP DBA <br /> Site Location 678 N WILSON WAY STE 3 RP mailing address <br /> STOCKTON,CA 95205 <br /> Cross Street PARK <br /> Mailing address 2155 W MARCH LN STE IA RP contact <br /> STOCKTON,CA 95207 RP contact phone <br /> Phone 209-942-2144 EXT: <br /> Owner: OW0001417-NOR-CAL CHICKEN <br /> DBA EL POLLO LOCO#3307 <br /> Owner address 406 MOTOR CITY CT BLDG D <br /> MODESTO,CA 95356--920 <br /> Billing Address 406 MOTOR CITY CT BLDG D <br /> MODESTO,CA 95356--920 <br /> Home Phone 209-942-2144 <br /> Work Phone 209-589-3224 EXT: <br /> District 001 -VILLAPUDUA,MIGUEL Location Code 01 -STOCKTON <br /> APN 14129003 <br /> Date Abated k�A <br /> Inspector ID <br /> --------------------------------------------- - --- - -- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: J <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 /> ,I)-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 /> omp aintReviewed y: , C p ate: Updatedy:q-Ite: <br /> 5104.rp1 <br />