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COPY #PI_Aeb un. n o /�AN JOAQUIN COUNTY PUBLIC HEALTH SERVICort 05404 <br /> COMPLAINT INVESTIGATION REPORT 09ge 1 <br /> 'COMPLAINT ## - 00005861 Program/Element 1600 <br /> Taken by : 0370 WILLIAM MARCHESE Date: 04/09/96 Assigned to 0740 <br /> Hard copy Printed: Date: 04/09/96 <br /> Facility Name: 'C— <br /> ...._._... F a c ID: <br /> Location. SgU_TH C©R ,OF CAI-.Z /LaCKFORD......LUpI_ BILL to inventoried FACILITY: <br /> (Must have FACILITY ID#) <br /> CamPAddress : Bp4.LEM1�.E BERS/PHS...-.EH Home Phone: <br /> .._...._Wor k Phone : <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: Loc Code <br /> Address-. SOUTH COR., .._._CALIF/� OCKEFORD SOS Dist. : <br /> City : ............_. . <br /> L Q D.I.. ... <br /> Phone : APN # : <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name: GF1R._...nTA_Z,L.I„ G..,..,SH0pHome Phone- <br /> Address ., <br /> city: ._........_...................Work Phone : <br /> Nature of Complaint: <br /> SELLING FOOD @ BUSINESS ( TACOS & OTHER FOOD ETC , ) I DON 'T THINK THEY <br /> HAVE A PERMIT TO SELL FOOD THERE . <br /> COMPLAINT Info — <br /> COMPLAINT MODE: O DTHER EH UNIT <br /> A-Agency Referral B-BD OF Supervisors/City CCORnCil C-Counter M-Mail/Correspondence <br /> 0-Other Unit P-Phone <br /> COMPLAINT STATUS: <br /> O1-Field Abated 02-Office Abated 03-NAI Sent 04-Notice tkAtatejssued 05-Enforce ACT Initiated <br /> Ob-Transfer to Premise File 07-Refer to Other Agency 8-Not Valid 09-Foodborne Illness <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: II III IV for Investigation <br />