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Date run: 12/05/97 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report 45104 <br /> Run by : KAREN Page # 1 <br /> Copy # : 01 of/our COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # C0009397 Program/Element : 1600 <br /> Taken by : 3304 ARMSTRONG Date: 12/05/97 Assigned to : 0794AAPHW Date: 12/05/97 <br /> Hard copy Printed: 44 e; - : Ci <br /> Facility Name: MARINA MARKETPLACE Fac ID: 007365 <br /> BILL to inventoried FACILITY: <br /> Location: 3201 BEN HOLT_DR, STOCKTON (Must have FACILITY IDI) <br /> Complainant : <br /> <br /> FACILITY LOCATION/Property Info - <br /> DBA or Name: Loc Code : <br /> Address : BOS Dist : <br /> City: APN # <br /> Phone: <br /> BILLING RESPONSIBLE PARTY or OWNER Info - <br /> Name: Home Phone : <br /> Address : Work Phone: <br /> City: <br /> Nature of Complaint: <br /> THE COMPLAINANT PURCHASED A FROZEN MEAL AND THE MEAL HAD A RAT TAIL <br /> UNDER THE CHICKEN. THE NAME OF THE IS "KID ' S CUISINE" AND CONAGRA <br /> FROZEN FOOD WAS ALSO ON THE LABEL. THE COMPLAINANT CALLED THE STORE AND <br /> STATE DEPT OF HEALTH SERVICES . <br /> fZb1Jl414ornPs00% —LILS D A4 <br /> COMPLAINT Info - <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> O-Other to Unit P-Phone <br /> COMPLAINT STATUS: 494 C5? <br /> 01-Field Abated 02-Office Abated 03-NAI imL 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File -Refer to Other Age cyr1f`shot Valid 09-Foodborne Illness <br /> Send Referral Letter to: ���� <br /> Address: <br /> Referral Letter Sent by: Date: <br /> Circle appropriate Unit I if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Pormarded to UNIT: 0 11 111 IV for Investigation <br />