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..�wr-i wi+.+.�.iv �.,vv�V 1 E r-ki CJ L- LI.. f"ICHL 1 h 0Lr' Vl Page Iu4 k . <br /> Run by CAROLD e 1 1 <br /> -:opyft 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # = C0011666 grogram/Elemerit 1619 <br /> Taken by : 9051 OSULLIVAN Date: 02/04/94 Assigned to : 0467 CARRUESCO Date: 02/04/49 <br /> Bard copy Printed: 02/04/99 <br /> Facility Name : LUCKY...Y...-S.T. #S 1O Fac ID: 000395 <br /> BILL to inventoried FACILITY: <br /> Location: 530._...._...._W....LODT...._AVE. (Must have FACILITY ID#) <br /> Complainant : S..TE.VE_ M.I_NDT........_...................... Home Phone:! 209-468-3920 <br /> Address : _............................................................._..........__.... . Work Phone:'I <br /> FACILITY LOCATION/Property Info — <br /> . ,t <br /> DBA or Name : LUCKY STORE......_#3.L.a......._. -Loc Code : 02 <br /> Address : 530 W LORI AVE . .. BOS Dist : 004 <br /> City- APIC._ . <br /> L©n_I„ '95241 <br /> Phone : 209-339-7170 <br /> :1 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name: LUCKY STORE INC Home Phone: 510--678-4200 <br /> Address: 1701 MARINA BLVD Work Phone: 209-339-7170 <br /> ....-_......................._.............._........_....._..........................................................................._............................................................................ <br /> City : SAf .._IwEAN©RG. CA 94577 } <br /> `A <br /> Nature of Complaint: <br /> FISH DEPARTMENT IS VERY DIRTY AND THE WHOLE AREA SMEELS LIKE ROTTEN <br /> FISH . ,i <br /> i+ <br /> i <br /> COMPLAINT Info — <br /> COMPLAINT MODE, C......._•.COUNTER ; <br /> .y <br /> A-Agency Referral B-BD OF Supervisors/City Ccauncil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> i <br /> iy <br /> COMPLAINT STATUS: <br /> 01-Field Abated 02-Office Abated 03-NAI Sent 04-N to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 07-Refer to Other Agency OB- t Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by : Date: <br /> Circle appropriate Unit # if compl int in another PROGRAM jurisdiction, Have Complaint Record and P/£ updated <br /> Forwarded to UNIT: I 11 111 IU for Investigation <br /> �r <br />