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CO0004782
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1600 - Food Program
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CO0004782
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Last modified
9/4/2020 1:27:19 PM
Creation date
2/8/2019 8:20:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0004782
PE
1619
FACILITY_ID
FA0000833
FACILITY_NAME
LUCKY FOOD CENTER MKT #186
STREET_NUMBER
1172
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
ENTERED_DATE
10/9/1995 12:00:00 AM
SITE_LOCATION
1172 N MAIN ST
RECEIVED_DATE
10/9/1995 12:00:00 AM
P_LOCATION
04
QC Status
Approved
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ADMIN
Supplemental fields
FilePath
\MIGRATIONS\M\MAIN\1172\CO0004782.PDF
Tags
EHD - Public
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Run by, SHELLY/"-A�-,_W�N JOAQUIN COUNTY PU3LIC HLA P, Repor� 151,04 <br /> 01 V Pa -, — <br /> V # <br /> COPY Of ()-L COMPLAINT IN—ESTIGATTON REPORT <br /> COMPLAINT # C0004782 <br /> TAeq by . 0628 SHELLY PRATER Dste: n/09/95 Pr,,,,)qram/E1.eme.,-jt_ 7 1600 <br /> Hard copy p-�in Assigned to <br /> t?d: 9157 MARK EXCELLDS Dat6: 10/.39/95 <br /> Faci)-itY Name ' L.U.C'.K Y I'D.I.S.0 0 UP T C E N <br /> .. . .. .... Fac- TD., 000s?-� <br /> Location: 1172- P� BILL to inventoried. ...... <br /> _t'4.AIN ST FACIL�TTY- <br /> Com,o na nt G;0DRIA. ;Rust have FACILITY 109.) <br /> Addr e-SS ... .... .... Home Phone - 209-824-1295 <br /> Phone. <br /> jpAZ4 'I ......Wor k <br /> FACILITY LOCATION/Property Info <br /> DBA of, Name : I-ucl<y DISCCA <br /> OT #186 <br /> N MAIN ST Loc. Cocje y 0. 4. <br /> C ity: r�l.AN_TECA 953a6 BOS Dist - <br /> Phone510 678 P N # <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name: LUCKY STORE 'INC <br /> AclTress= 1 7 1 01 .,Home 'hone : 510-678-420(� <br /> Work pl-lwle, <br /> CitY: SAN LEANDRO CA 9457? <br /> �13tljfe of cuplaint; <br /> A CHILD WAS STANDING- Ota! THE CONVEYER BELT AND TAKTNG, BITES OUT OF CA_mD <br /> TES AND . SPITTING THEM BACK INTO THE CONTAINER <br /> COMPLAINT Info <br /> COMPLAINT MODE: P NONE <br /> A-Agency Referral B-BD OF SUPOVASOrSIC"Y CCOUC111 C-COUrter M-Mall/Corres.pofidence <br /> �-ftheT EH Jrit P-Phone <br /> 'I'VIPLAItJ STAT'OS; <br /> 2 <br /> ril-Field Abated 02-office Aba`ed 03-MAI sent 04-Notice to Abate issued 05-Enforce AC' Initiated <br /> 06-Transfer to Premise File 07-Refer to Other Agency 08-Not %Ialid 09-Foo8vne 11'pess <br /> cir,le appropriate Unit 0 if comp. lairt ir. anot-.ter DR4GPI? jurisdiction, Lave Cooplaint Rn-3rd and PIE updated <br /> Forwarded to 017i' I! H! 1V for Investiqati6n <br />
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