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Date run: 0:',/08/95 <br /> Rt.�n by SHELLY SAN JOAQUIN COUNTY PUBLIC HEALTH SER47TC Report #5104 <br /> �� <br /> COPY 01 of 01,, COMPLAINT INVESTIGATION REPORT Page #i 1 <br /> COMPLAINT '# = 00003455 Program/Element : 1600 <br /> Taken by : 0254 JIM MILLER Date: 03/08/95 Assigned to 5756 ERNESTO JACO80 Date: 03/08/95 <br /> Hard copy Printed: <br /> Facility Name: S.Af=. WAY......ST( R .S_.._ 12 4 Fac ID: 002980 <br /> BILL to inventoried FACILITY: <br /> Location- 195p lJ1TM �.Y (Must have FACILITY ID#) <br /> Complainant : <br /> : <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name : SAFEWAY Code : 03 <br /> Address : 1'9"5'6 W- 1.. ...T..H..__STREFT .._.... BOS Dist <br /> City : ......._ ...... <br /> TRRCY. APN # <br /> Phone : <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name: <br /> .. ........._..........................._ _ ._............_................._..__.................................... . Home Phone : <br /> Address: Work Phone: <br /> City : <br /> Nature of Complaint: <br /> AMMONIA SMELL AROUND FISH DEPART . INDICATES BAD SHRIMP/CRAB MEAT DEPT . <br /> SELLS OLD/BAD MEAT FACILITY APPEARS TO BE DIRTY <br /> COMPLAINT Info — <br /> COMPLAINT MODE: PPHONE <br /> ............ <br /> A-Agency Referral 8-8D OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> 0-00er Eli Unit P-Phone <br /> COMPLAINT STATUS: <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 lot Valid .09-Foodborne Illness <br /> Circle appropriate Unit 4 if complaint in another PROGRAM jurisdiction, Have Complaint Record and PIE updated <br /> Forwarded to UNIT: II III IV for Investigation <br /> ~h <br />