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Date run: 07/22/93 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 <br /> Run V ROSEMARY page # 1 <br /> Copy # 01 of O1 CDMPLAINT INVESTIGATION REPORT <br /> 9M <br /> COMPLAINT <br /> COMPLAINT # C0000343 Program/Element : 1600 <br /> Taken by : 0519 ROSEMARY FLORES Date: 07/22/93 Assigned to : Date: 09/22/93 <br /> Facility Name : _ Fac ID: <br /> //,2-0 9 BILL to inventoried FACILITY: <br /> Location: HAMMER LANE ( STOCKTON ) (Must have FACILITY ID#} / D <br /> Complainant : <br /> <br /> <br /> FACILITY LOCATION/Property Info - � <br /> DBA or Name: SS�e- /f7"IW _ Loc. Code : 01 <br /> Address : _ _ /�i7/hE�- SOS Dist : <br /> City: APN # <br /> Phone : <br /> k OWNER Info - v <br /> BILLING Party: <br /> Owner/Agent: Home Phone : <br /> Address : Work Phone : <br /> y City: _ <br /> i <br /> Nature of Complaint: v % <br />` - HAMBURGER 2 PKG - DOC OR CONFIRMED FOOD POISONING - 8 PEOPLE <br /> TOTAL IN FAMILY WHO ARE ILL - PKG DATE ON MEAT 7/18/93 - ATE IT <br />` ON 7/18/93 - <br /> 3. M t to I <br /> te S. SH w FICA MG6ixet �' Cn►ece�) <br /> (v- 0_,kC1c,) UA 1 ba* S --•1g (^efkJ—) <br /> COMPLAINT Info - <br /> COMPLAINT MODE, P PHONE <br /> A-Agency Referral B-BD OF Svpervisars/City"Ccouncil C-Counter M-Hail/Go rrespondence <br />` O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: <br /> 1-Field Abated 02-Office Abated 03-NAI Sent 04-Hatice to Abate Issued 05-Enforce ACT Initiated <br /> O6 Transfer to Premise File 07-Refer to Other Agency 08-Not Valid 09-Foodborne Illness <br /> 1 <br />, <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and PIE updated <br /> Forwarded to UNIT: I II III IV for Investigation <br />