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.. ..,�. j �L,unir ruBLIC HEALTH SERVIC Report #5104 <br /> Bun by sYLVIA <br /> Copy # 01 of 01 COMPLAINT INVESTIGATION REPORT Page # 1 <br /> 1M1�lMMMAIAIMMI�lAIFlAlA1MMMMMMMMAIAtAIMAIMAIAMIMAlMMhIMhIAIM�MMMM�� <br /> COMPLAINT E CO001578 Program/Element : 1B00 <br /> Taken by : 7354 SYLVIA MARTINEZ Date: 03/18/94 Assigned to : 7479 RON ROWE Date: 03/18/94 <br /> Facility Name: SAFEWAY STORES 01264 Fac ID: 202980 <br /> Location: 1950 W 11TH BILL to inventoried FACILITY: <br /> (Must have FACILITY ID#) <br /> Complainant: ROBERT WHITTER <br /> <br /> <br /> property Info - <br /> DBA or Name: SAFEWAY Loc Code 03 <br /> Address! 1950 W 11TH ST SOS Dist 005 <br /> City: TRACY 95376 APN # <br /> Phone: 209-239-9327 <br /> BILLING RESPONSIBLE PARTY or OMIER Info - <br /> Name: SAFEWAY Howe Phone: <br /> Address: 47400 NATO RD Work Phone: <br /> City: FREMONT CA 94537 <br /> Nature of Complaint: <br /> BOUGHT FRESH FISH b FOUND A WORM IN IT - <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 EH Unit P-Phone <br /> COMPLAINT STATUS: SL i! <br /> 01-Field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 07-Refer to Other Agency 08-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: I II III IV for Investigation <br />