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Date run: 08/05/96 SAN JOAQUIN COUNTY PUBLIC HEALTH SER'VIC Report 15104 <br /> Run by : MARYF/Co- Page # 6 <br /> Copy # : 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # : C0006604 Program/Element : .23el ' <br /> Taken by : 0988 KASEY FOLEY Date 08/05/96 Assigned to : 3973 ROBERT MCCLELLON Date: 08/05/96 x,53 <br /> Hard copy Printed: <br /> Facility Name : JIFFY_LUE3E Fac ID : 003741 <br /> BILL to inventoried FACILITY: <br /> Location: 1130_ N MAIN (Must have FACILITY ID#) <br /> Complainant : <br /> <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: JIFFY LUBELoc Code 04 <br /> ................ ... <br /> Address: 1130., N .MAIN <br /> _ _.. BOS Dist : <br /> City : MALATE.C_,A 95336 APN # <br /> Phone : 2-092-3906 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name: FOWLER_ ,DICK---. . ...... _. Home Phone : <br /> Address : <br /> <br /> Nature of Complaint: <br /> WAST OIL UST OVERFLOWED ONTO NEIGHBORING PROPERTY . <br /> COMPLAINT Info — <br /> COMPLAINT MODE A AGENCY REFERRAL <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: <br /> 01-Field Abated -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 OB-Not 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: I II III IV for Investigation <br />