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Uate run : 04/08/99 SAN JOAQUIN COUNTY PUBLIC HEALTH SER'VI-- Report #5104 <br /> R,un by_ : CAROLD Page # 1 <br /> Ccfpy # : 01 of 0 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT ## C0012063 Program/Element : 1320 <br /> Taken by : 6519 DISA Date: 04/08/99 Assigned to 3497 OUINLIN Date: 04/08/99 <br /> Hard copy Printed: <br /> Facility Name : Fac ID : <br /> BILL to inventoried FACILITY: <br /> Location: ACROSS FROM 780 E 11th (Must have FACILITY ID#) <br /> Complainant : <br /> <br /> <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name : Loc Code : <br /> Address : ACROSS FROM 780 E lith BOS Dist : <br /> City : TRACY 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 /> BURNED OUT TRAILER , NEEDS TO BE CLEANED UP . SMELL I�� GETTING BAD . <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: 01- <br /> 01-Field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enfonce ACT Initiated <br /> 06-Transfer to Premise File 07-Refer to Other Agency 08-Not valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by: _.� Date: _ —___.__� <br /> Circle appropriate Unit ' if compl nt in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: II III IV for Investigation <br />