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port <br /> Date run: 01/19 9�, SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC PageA # 4 1 <br /> Run by : LOLA <br /> Copy # : 01 offffff 01 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # = COOO538O Pro nt <br /> Taken by : 1968 JERRY YOSHIOKA Date: 01/19/96 Assigned to : 19 JERRY YOSHIOK ate: 01/19/96 / <br /> Hard copy Printed: Fac ID' <br /> Facility Name: — BILL to inventoried FACILITY: <br /> Location= SOUTH OF 21123 5 JACK_TONE_,RD <br /> (Must have FACILITY IDI) <br /> Complainant: COUNTY FIRE DISPATCH _ —_ Home Phone: 209-468-4418 <br /> "Work Phone: <br /> Address: <br /> FACILITY LOCATION/Property Info — <br /> _Loc Code : <br /> DBA or Name: --.._..— -- _— BOS Dist : <br /> Address: __--. ---- APN # <br /> City: _ <br /> Phone: <br /> BILLING RESPONSIBLE PARTY or OWNER Info — Home Phone: <br /> Name: i ---.—..----- <br /> --------------------------.._.—.........._. Work Phone: <br /> Address: ---- — ---...— —.— .—.— — <br /> City: <br /> Nature of Complaint: <br /> PESTICIDE ABANDONED ON SIDE OF ROAD <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: C—) \. <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 OZ-Refer to Other Agency 08-Not Valid 09-Foodborne Illness <br /> Circle appropriate Unit # if .complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I IIIII, IV for Investigation <br />