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Date runt 12/03/9 SAN JO,�QUIN COUNTY PUBLIC HEALTH SERVIC Report 15104 <br /> Run by GAROLD -'� Page # 2 <br /> Copy #. 01 of 1 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # C0007320 Program/Element--' ].a-29, l3 22 <br /> Taken by : 0628 SHELLY PRATER Date: 12/03/96 Assigned to : 0843 MICHAEL COLLINS Date: 12/03/95 <br /> Hard copy Printed: <br /> Facility Name: — Fac ID: <br /> Location: 317N. GOLDEN GATE '��` G1� Q BILL to inventoried FACILITY=' <br /> (Must have FACILITY 101) <br /> Complainant. TAMMY MORS _.._ _ _Home Phone: 209--941 -0334 <br /> Address: _ �_ -Work Phone, <br /> FACILITY LAC'ATION/Property Info — <br /> DBA or Name: _ �__ Loc Code <br /> Address: _.___. ____.___.�_,�__._. _� _ _ <br /> —. —__ BOS Dist : <br /> City: _ APN # <br /> Phone: 4y. y24- 24 <br /> BILLING RESPONSIBLE PARTY .or OWNER Info. _ <br /> Name: CHARLIES Li�AN _ _ _ Home' Phone'. <br /> Address: 3009 E.. MINER AVE _wWork Phone: <br /> City: S10CK10N CA -- ------_ ____ <br /> Nature of Complaint: <br /> NO BATHROOM SINK , KITCHEN WINDOW POPS OUT . BACK DOOR WON 'T LOCK , WC <br /> .MICE . WIRING SPARKS, <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral BAD OF Supervisors/City Ccouncil C-Caunter M-Mail/Correspondence <br /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: _Q4! <br /> 01-Field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> - tans remise File 07-Refer to Other Agency 08-Mot Valid 09-Foodborne illness <br /> Circle appropriate Unit 1 if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: 11 111 IV for Investigation <br />