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Dat_ep run: 10/16/96 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 <br /> Aunby : KAREN{ Page # 18 <br /> Copy # : 01 of COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # : 00007061 Program/Element : 1600 <br /> .Taken by : 9051 MARY OSULLIVRN Date: 10/16/96 Assigned to Date: 10/16/96 <br /> Hard copy Printed: <br /> Facility Name: Fac Fac ID: <br /> BILL to inventoried FACILITY: <br /> Location: 3201_ W . B.ENJAM,IN....,_HOLT....._SU.IL E._„99 (Must have FACILITY IDI) <br /> Complainant: NATDEEN CHERRY Home Phone: <br /> ....................................................................................................................._._.__..._......._....... <br /> _..._._...._._..................... <br /> Address: 957...-2573._............. Work Phone : <br /> FACILITY LOCATION/Property Info — <br /> DBAor, Name: .. ....`........._...............................:...............................-.. Loc Code <br /> Address: BOS Dist <br /> ..._.......__........._......._._....__......._.......................__................................................................................................................�....- <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 F=OOD HAD BUG IN IT . <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral B-8D OF Supervisors/City CCQuncil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: d� <br /> 01-Field Abated 02-Office Abated O3-NAI Sent 04-Notice to Abate Issued 05-E00rce ACT Initiated <br /> 06-Transfer to Precise File 07-Refer to Other Agency 08-Nat Valid 09-Foodborne Illness <br /> Circle appropriate Unit I if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: �I II III IV for Investigation <br />