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T - v11'�41> SAN JOAOIJTN r AJNTY PUBLIC HEALTH SERVIr Report 15104 <br /> twu' -ay CAROLD Page # 1 <br /> Copy # 01 of I COMPLAINT INVESTIGATION REPORT <br /> MMMMMNINIMMMMMMMNINIMMMNIhIMMMMMMMMMMMMMMMMMNIMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM <br /> COMPLAINT # = C0012986 Program/Element : 2500 <br /> Taken by : 3188 PARKER Date: 09/21/99 Assigned to 3188 PARKER Date: 09/21/99 <br /> Hard copy Printed: <br /> Facility Name : VILLAGE„ WEST__MARINA Fac ID : 003830, <br /> BILL to inventoried FACILITY: <br /> Location: 6649 EMBARCADERO DR (Must have FACILITY ID#) <br /> Complainant: <br /> : <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name : VILLAGE WEST MARINA Loc Code : 01 <br /> Address : 6649 EMBARCADERO DR HOS Dist : 002 <br /> City : STOCKTON 95209 APN # <br /> Phone : 209-951-1551 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name : LINCOLN VILLAGE WEST MARINA LT Home Phone : 209-951-1551 <br /> Address: 6649 EMBARCADERO DR Work Phone : 209-951-1551 <br /> City: STOCKTON CA 95209 <br /> Nature of Complaint: <br /> SANDING BOAT IN WATER , SAWDUST AND PAINT GOING IN WATER <br /> COMPLAINT Info — <br /> COMPLAINT MODE: A AGENCY REFERRAL <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncii C-Counter M-Mail/Correspondence <br /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: D.'.. <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 /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by : _ _. Date: _ <br /> Circle appropriate Unit # it complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I II III IV for Investigation <br />