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� <br /> � ^ 1D/�S/�4 SAN JOA�UIN COUNTY PUBLIC HEALTH 5ERVIC Report 45104 7 <br /> Date run: Page # <br /> Run by : LAURIE COMPLAINT INVESTIGATION REPORT <br />� <br /> Copy # ' 01 of 01 <br /> Program/Element 1600 <br /> COMPLAINT C0002811 <br /> Taken by : 1562 LORETTA DUNHAM Date: 10/25/94 Assigned to Date'. 10/25/94, <br /> Hard copy printed: <br /> Facility Name : T.I.0 PEPES Fac ID ". 002699 <br /> °^^^ .. ^.~._-- FACILITY:_ _—_—_ <br /> (Must haveFACILITY �O) <br /> Location: <br /> Complainant: <br /> <br /> _ <br /> ` <br /> FACILITY LOCATION/PropertY Info — <br /> DBA or Name: Loc Code : <br /> 0S Dist : 0�� <br /> Address ', <br /> City: _ A, " # _ . <br /> Phone., <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Home Phone : <br /> Name .' <br /> Address: Work Phone: <br /> City '. <br /> Nature of Complaint: <br /> ROACH INFESTATION , ROACH RAN ACROSS TABLES <br /> ��. <br /> 1994 <br /> COMPLAINT Info — -` <br /> �V <br /> COMPLAINT MODE: pPHON[ ,«~ZS~ '' <br /> A-Agency Referral 8-U0 OF Suporviuoru/Cdy Cvvuncil C'Cuuotm M-Hail/Co//esp*ndonco <br /> O-Othm EH Unit 9-Phone <br /> COMPLAINT STATUS' <br /> 01-Field Abated Abut d 02-Officm Abated 03-NA Sent 04-Notice to Abate laauod 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 07-Refo/ to Other Agency 08-NMt Valid 09-Foodborne lL\oemn <br /> . <br /> Circle aPProp iote Unit I if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: l II III [Y for Investigation <br />