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— Report �aivy <br /> Date run:' 10/01./9` SAN JOAC�UIN COUNTY PUBLIC HEALTH SERVIC Page # 1 <br /> Run -by = CARQLO <br /> CA of 01 COMPLAINT INVESTIGATION REPORT <br /> COPY # }NlN1NJ�1NlMN1�`}MN}M1`}MMM!'�NIN}Nf!"}Mlf1}NJIJJ~}"dfl}N}1'} N}�y}NH�J►'U`1NfN}`FT}N}!}N#2OdN}11'fNfA}Jff1yJN}N}T}N})`'f <br /> MMMN}Nn 9M1 NlJ��NfMJ�f1�}1�1N}Nf}� P r o g r a m/E l e m e n t <br /> COMPLAINT # r C0013047 Assigned to 0467 CARRUESCO Date: 10/01/49 <br /> Taken by : 0467 CARRUESCO Date: 10/01/94 <br /> Hard copy Printed F"ac. ID: 04427'.5 <br /> Facility Name i`1.OKELUMNE... R_z ....- CQD BILL to inventoried FACILITY <br /> (Must, have FACILITY 190) <br /> Location= '.189.5.C1....... ...... i^!Y...._9 J. . <br /> Home Phone: <br /> Complainant: P_TRENT......0:�...... UfEI T.__._�..CHR. B......_.._.:.....:...._.........._.........Work Phone' <br /> Address : - _......_._..... ._..................._. <br /> FACILITY LOCATION/Property Info - Loc Code : 99. <br /> g g . ..:.........._.......................,..,...._................__.__......_..._..... <br /> DBA or Name" E30S Dist : 004 <br /> M_DK�LUMNCw......F2I,VER....._5C_HO...._ ........................ <br /> Address= 18950.....N......H..w...Y...........__...:...___......... APN # WGMOK_EL.18.. <br /> City : 1-011_ 95241. <br /> Phone : 209-368-7271 <br /> BILLING RESPONSIBLE PARTY or OWNER Info _ Home phone: <br /> ......_.........._._,............. <br /> Name ' GOENRI_NG..a...._.CLIEE©R4 .....__..............._.........:_.._..._ Work Phone- <br /> 209-368-7271 <br /> Address 1_$950 ...N...HW ....J ._...._.._.. <br /> City: LQD_I.. CA_ 95241 <br /> Nature of Complaint: <br /> THERE ARE EXISTING PORTABLES ON SITE THAT ARE NOT BEING USED . THEY A <br /> RE <br /> Up ON JACKS AND KIDS ARE CRAWLING UNDERNEATH TO RETRIEVE SOCCER BALLS ,. <br /> ETC . VERY DANGEROUS . <br /> COMPLAINT Info - <br /> COMPLAINT MODE: PPHONE <br /> A-Agency Referral S-BD OF Supervisors/City CCOUPCII C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: 0.,7 <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 /> Send Referral Letter to: _ <br /> Address: <br /> Referral Letter Sent by: Date: <br /> Circle appropriate Unit 9 if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I II III IV for Investigation <br />