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Date run: 08/2E3f SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 <br /> /r• <br /> Run by : MARYF /� Page # 6 <br /> Copy # : O1 of 0 COMPLAINT INVESTIGATION REPORT - -/ <br /> COMPLAINT # : C0006793 Program/Element <br /> Taken by : 8714 MARY FRANKS Date: 08/28/96 Assigned to .? CAROL OZ Date: 08/28/96 <br /> Hard copy Printed: ___ 4756 /3 2 2- <br /> Facility <br /> Facility Name : Fac ID: <br /> BILL to inventoried FACILITY: <br /> Location: 317.....N......,,_GOLDENGATE. (Must have FACILITY ID#) <br /> Complainant : VI,RGI_N,I,A,.-FAI-R...,._HOUSINCi.............. Home Phone: <br /> Address: <br /> ln�nr✓JLe----- . . ..._........ Phone : 209--944..-8005. <br /> FACILITY LOCATION/Property�lI,nfo — <br /> DBA or Name CA urlY .....Nt°i Sq/,nU <br /> J /'J Loc Code <br /> Address : • <br /> City. �j. .E/n.�_c� � ... .........:_ ................ SOS Dist <br /> Phone: S+ CA 9 j"o20 S APN <br /> BILLING RESPONSIBLE PARTY or OWNER Info — � 9 <br /> Name: <br /> Address: Home Phone: <br /> — <br /> City: Work Phone : <br /> ............ <br /> Nature of Complaint: <br /> KITCHEN SINK DRAINS OUT TO THE GROUND, NO SMOKE ALARMS , PLUMBING BACK— <br /> ING UP INTO HOUSE , ROACHES , & POWER POLE ABOUT TO FALL OVER IN BACKYAR <br /> COMPLAINT -Info — <br /> COMPLAINT MODE: A..,..,_.._AGENCY REFERRAL <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: <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 /> L, <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I 0 <br /> III IV for Investigation <br />