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Reviewed by: Date: <br /> Complaint Record Updated By : Date : / / f <br /> J evised Report #5104 718/9S ; <br /> 1 <br /> Date run: 08/31 /93 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 k <br /> Run by : SYLVIA Page # 2 <br /> Copy # : 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM <br /> COMPLAINT # : C0000603 Program/Element : 4200 <br /> Taken by : 0794 RAJU MATHEW Date: 08/31/93 Assigned to 0794 RAJU MATHEW Date: 08/31/93 <br /> E <br /> Facility Name: Fac ID: <br /> BItL to inventoried FACILITY: <br /> Location: 30000 KASSON RD TRACY Must have FACILITY ID#j <br />�. Complainant: Home Phone: <br /> <br /> r FACILITY LOCATION/Property Info — <br /> DESA or Name: Code 03 <br /> Address: BOS Dist 005 <br /> City: _ APN # : <br /> Phone : <br /> OWNER Info — BILLING Party: _ <br /> Owner/Agent: SAN JOA UIN RIVER CLUB Home Phone : <br /> Address: Work Phone: <br /> City : <br /> q <br /> -Nature of Complaint: <br /> — SEPTIC SYSTEM APPEARS TO BE MALFUNCTIONING — <br /> I <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral B-BD Of Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> O-other Ell 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-Nat Valid 09-Foodborne Illness <br /> x <br />