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12/28/95 SAN JOAQUIN COUNTY PUBLIC HEALTH SER # <br /> Page <br /> to run"_ �7ARYF COMPLAINT INVESTIGATION REPORT <br /> �Pyb� : 01 of o1 Program/Element <br /> COMPLAINT # ' <br /> C0005230 12/28/95 <br /> Assigned to p <br /> Date" 12/28/95 <br /> Taken by : 8714 MARY FRANKS Date: 1 V I� BILL to inventoried FACILITY <br /> Hard COPY Printed: Fac ID- <br /> Facility Name" (Must have FACILITY IDR) <br /> Location: JACKTONE...RD,_ 1/2,._M, N • OF HWY._G.. <br /> Home Phone <br /> Complainant= <br /> <br /> <br /> <br /> <br /> ......................._................_.............._. <br /> FACILITY LOCATION/ProPerty Info — Loc Code <br /> DBA orName"• _ - <br /> .BOS Dist <br /> Address - - -" <br /> AP # <br /> City, <br /> Phone: <br /> BILLING RESPONSIBLE PARTY or OWNER Info — Home Phone : <br /> Name : ..._. Work Phone' <br /> ............. <br /> Address: <br /> City : ...... <br /> Nature of Complaint: <br /> DURING THE RAIN & WINDS A TRANSFORMER FELL OVER SPILLING OIL ONTO THE <br /> OF <br /> ANFIELD&5/8IMILEEE . OFNUND JACKTONETESD RDI.EONNON TTHEDTOGNIASIT IS IN THE MID . <br /> RANCH . <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: QZ <br /> 01-Field Abated 02-Office Abate 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Preaise 1 e 07-Refer to other Agency 08-Not Valid 09-Foodborne Illness <br /> Circle appropriate Unit Y if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I II 0 <br /> IV for Investigation <br />