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j , �� to I-on: 10/05/94 ::AN JOAQUIN UOUN i Y PURL- J.Ca 'HE'Af_ TH w)ERVIC Report #5104 <br /> r1 <br /> by : SYLVIA Page #f 9 <br /> j oy ## : 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> j COMPLAINT # = 00002663 Prograrn/Elemernt = 1300 <br />' T8ken by : 6915 CARL BORGYAN Date: 10/05/94 Assigned to 0359 ALAN BIEDERMANN Date: 10/05/94 <br /> I <br /> k <br /> Facility Name: IM;.CJ. D ON E..RS.._A P.A R.;T-M.E �. Fac ID: 00 4179 � <br /> BILL to inventoried FACILITY: y <br /> Location: 4835.....W 11TH (Must have FACILITY ID#)' <br /> j <br /> <br /> i <br /> FACILITY LOCATION/Property Info <br /> DBA or Name : i, Q4�.DONERS APT-. Loc. C'afle OS <br /> � <br /> : <br /> Address : 4835...:-..._......_. ... B0S Di St~ 095 j <br /> City: TRACY 95 376 APf,,I � 1 <br /> Phone : <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name- THOMAS T RAM __..... Herne Phone: <br /> Address - 483 ..._.W 1.IT. HWork Phone : I <br /> City : TRACY C 95:76 j <br /> j I <br /> j mature of Complaint: <br /> f — HOLES IN WALLS BUILDINGS DETERIORATING FILTH AND REFUSE" ABOUT TH 1 <br /> E PREMISES <br /> I <br /> i <br /> i <br /> j <br /> I 1 <br /> I � <br /> I j <br /> COMPLAINT Info <br />� _ I <br /> COMPLAINT MODE: P_ PHONE J <br /> j A-Agency Referral 3-BD OF Supervisors/City (council C-Counter M-Mail/Correspondence ; <br /> i O-Other EH Unit P-Phone ! <br /> COMPLAINT STATUS: <br /> i <br /> I <br /> j 01-Field Abated 02-Office Abated O3-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated j <br /> 00-Transfer to Premise File 07-Refer to Other Agency 08-Nat Valid 09-Foodborne Illness <br /> 1 <br /> f , <br /> j Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Rave Complaint Record and P/E updated <br /> f forwarded to UNIT: I II 111 IV for Investigation <br /> i 1 <br /> j I <br /> j <br />