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a <br /> s <br /> RB�eb�un: � ��+ SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 <br /> Copy # : 01 of _COMPLAINT INVESTIGATION REPORT Page # 1 <br /> COMPLAINT # : C0005909 Program/Element : 1600 <br /> Taken by : 9051 MARY OSULLIVAN Date: 04/11/96 Assigned to : 0843 MICHAEL COLLINS Date. 04/11/96 <br /> Hard copy Printed: <br /> Facility Name: AL XAN.D .R°.. ._....B,AKE=RY Fac ID- 000175 <br /> ............... <br /> BILL to inventaried FACILITY: <br /> Location: ] 1_p©.. 1 L pP AVE (Mutt have FACILITY 10#) <br /> Complainant: p,Eg.B.I_E. ..PROUL. ....... Home Phone: 209--295-2503 <br /> Address : __._,..._.Work Phone- <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: ALEXAND ;S BAKERY Lac Code <br /> ....................... ................... <br /> Address : 110C1,,,,,W LODI ,A,VE .BOG Dist : <br /> ........... ..... ............... .........._._..... <br /> City: L.Q.D. I APN # <br /> Phone : <br /> BILKING RESPONSIBLE PARTY or OWNER Info — <br /> Name : JOHN ,M_ARY....._AND DAV_ID......M€INDAV_I._........ .. ,_ ......... ..._........_..._Home Phone: <br /> Address: I_I00 W._.L.4D,I„ AVE. Work Phone : <br /> City : LORI CA, 95240 <br /> Nature of Complaint: <br /> WHILE DRINKG SOFT DRINKS BOTH CUSTOMERS ' NOTICE PARTICLES IN THEIR <br /> DRINKS . POSSIBLE" FOOD OR SOFT ©RINK MACHINE WAS DIRTY . <br /> COMPLAINT . Info — <br /> COMPLAINT MODE: P PHONE <br /> .................. <br /> A-Agency Referral B-BD OF Supervisors/City CCauncil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: V7- <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 /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: QIII III IV for Investigation <br />