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rUn= 03/074/9 ,SAN JOAQC ;IN COUNTYPIJBL.TG HEALTH SFRVIC Report, x5104 <br /> Run by : MARYO Page # ' <br /> Copy # 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # = 00004383 Program/Element = 1600 — <br /> Taken by : 0740 BRUCE ASKANAS Date, 03/04/95 Assigned to 0740 BRUCE ASK.4AS Date: 03/04/95 <br /> !lard copy Printed. <br /> Facility Name , Fac ID: <br /> BILL to inventoried FACILITY: <br /> Location 40..E WENH1 .:.RTH (Must 1,ave FACILITY IDP) <br /> C:orrnplainant: UNIT IV Home Phonis <br /> Work Phone <br /> FACILITY LOCATION/Property Info — <br /> IBA or Name: Loc Code : <br /> Address: BOS Oi6t <br /> City. A.PN # <br /> Phone. <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name : Home Phone <br /> Address: Work Phone : <br /> City , <br /> Nature of Complaint: <br /> AMONIA LEAK AAT BAKERY <br /> COMPLAINT Info — <br /> COMPLAINT MODE1 0 OTHER EH UNIT <br /> A-Ageacy' Referrs I 8-5D OF Supervisors/City Ccouncil C-Counter M-Maii/Correspondence <br /> O-Other EH Unit ?-Phone <br /> COXPLAINT STATUS: <br /> 01-Field abated 02-04ffice Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> Ob-Transfer to Premise File 07-Refer to Other Agency 03-Not valid 09-Foodborne Illness <br /> Circle appropriate Unit I if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: II IIT. Tv for Investigation <br /> 1 <br />