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r � <br /> Date run: 12/08/94 SAK JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report 15104 <br /> Run by : CAROLINE Page # 8 <br /> Copy # : 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # C0003013 Program/Element : 4200 <br /> Taken by : 0467 JEFF CARRUESCO Date: 12/OT/94 Assigned to : 0467 JEFF CARRUESCO Date: 12/07/94 <br /> Bard copy Printed: <br /> Facility Name: JACKS PLACE Fac ID: 003221. <br /> BILL to inventoried FACILITY: <br /> Location: 7939 W 11TH ST (Bust have FACILITY 1114) <br /> Complainant : <br /> <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: JACK ' S PLACE Lac Code : 03 <br /> Address : 7939 W 11TH BOS dist : 005 <br /> ` City: TRACY APN # <br /> Phone : 209-832-3399 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name : LOUIE DARRIGO MGR.JACK MAH Home Phone: <br /> Address : 7939 W tt.TH _ Work Phone: <br /> City: TRACY CA <br /> Mature 01 Complaint: <br /> PERFORMING WORK ON SEPTIC SYSTEM W/O PERMIT <br /> COMPLAINT Info . — <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral R-BD OF Supervisors/City Ccouneil C-Counter M-Mail/Correspondence <br /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: <br /> Field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 6-Transfer to Premise File 07-Refer to Other Agency 09-Not Valid 09-foodborne Illness <br /> Circle appropriate Unit 1 it complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: 1 11 111 IV for Investigation - <br />