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Fate run? 12/08/qp SAN JOAQUIN COUNTY PUBLIC HE AL IM `_>�-KVO— Rt�"VIL ":x <br /> Run by : DENORAw Page �:� 6 <br /> Copy it : 01 of 01- COMPS -AINT INVESTIGATIONRE. ORT <br /> N1.�'fMNIMNI�'fNfNfl'�NlN1NINIMNI Nfl?NfNfNINfNfNfNFMN1N1NINfNfNfNlN1N1N1NJ�'fN1!'�1'�1'�NINfNf1'1�'�1'�NfMN1N1MNlN1N1N1N1NfNfNfP'1Nft�INfNtNINfNf N1MN1NfNf!`'1MNf��Nf <br /> COMPLAINT # = 00011361 Program/Element 1626 <br /> Ta Mer. by ' 7824 GAGAZA Date, 12/0e/98 Assigned to 0467 CARRUESCO Date: 12108198 . <br /> Hard dopy Printed: <br /> Far i,1 i t.y Name : 1....Z.TT.L-E ..SOS_-.OF LODI Fac ID ! 003926 <br /> BILL to inventoried FACILITY: <br /> Location: 1230 W F«T LEM..A.N. LN (Aust have FACILITY IDA) <br /> Complainant ; JFFF ... Home Phone: 209-333--6740 <br /> Address- cork Pone= <br /> FACILITY LOCATION/Property Info - <br /> DBA or Name= LITTLE J_OES.... O :,...._L_QDI ............... .. Loc Code 02. <br /> Address. 1230 i4 KETTI_EMAN LN - OS Dist = 004 <br /> City LOD,1- 95240 <br /> APN = <br /> Phone: 209-333--1554 <br /> BILLING RESPONSIBLE PARTY or OWNER Info. - <br /> Name" <br /> nfo -Name: NELSON...,... CHEBY_L.... ....... RHome Phone : 209-334-3400 <br /> Address: 812_ PERRY WAY. ....._...._....... k Phone* 209-333--1.554 <br /> City LOD,I C1, 95240 <br /> Nature of Complaint: <br /> ROACHES IN MENU AND KITCHEN , BREAD STACKED ON FLOOR <br /> 'i <br /> COMPLAINT Info -- <br /> J <br /> 3 <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral B-8D OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: <br /> ^1-Field Abated 02-Cff.rP Abated 03-NPI Seet 04-N,';­ to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File, 07-Refer to Other Agency OB Not Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address= <br /> a <br /> Referral Letter Sent- by : �. _ Date- <br /> a <br /> Circle approPriate Unit A if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/t updated <br /> Forwarded to UNIT: II III IV for Investigation <br />