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€ N .JOAQUIN CO ,JINTY PI.:Bk_IC '�A;LTH SERVIC Re^ort X5104 <br /> Rt it. k3'y �- : P�kri!�y <br /> copy._ # 01 v? 01 COMPLAINT If�VEC-TIGATION REPORT Page. �# 1 <br /> COMPLAINT # = C0C3O4595pry .�I. �I 1 'rJ ement5 <br /> �W .=. 247 <br /> Taken by : 0997 HARLIN KNOLL Date: 09/07/95 Assigned to : 0997 riARLIN KNOL4 Date: 09/07/95 <br /> Hard copy Printed: <br /> Far:iiity Narrie ' Fac ID. <br /> Location= ilARTP,,-ar � /� <br /> BILL to inventoried FAC.}ITY. <br /> .. .......... -....._... l l: ......F...OF Ml RPljy (Must have FACILITY I0�` <br /> Comp la.i rantQFIP/DON PERRY Home pi-lone" <br /> AddA`3.D_ ARTWork: Phc-)ne= <br /> FACILITY LOCATION/Propetty Info — <br /> DBA or Name= BCOY�'TT. PETROLEUM Loc Cc -e . <br /> Address : Dist <br /> ....... . .. ........._._. <br /> Cit-y ; APN 0 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Nariic�= UAG'i= F3OY4` TI Home, Phone." ?09-- 5-45-11 ?2 <br /> ess- 4320 KIERNE;AN .AVE a JITE__.2rJ(3Works Phon:: ; <br /> City- MOUES.. < C.A. 95356 <br /> Nature o Complaint., <br /> 83 00O GAL. GAS Sk"1L.L.E D INTO DRAIN DITC,l DIJE; TO VU-1,11-CLE ACCIDENT . HK- <br /> RESPONDED <br /> COMPLAINT Info — <br /> COMPLAINT MODE: <br /> A-Agmy Referral E-BD OF 5 peraisorsJCity Cceuncil C-f'ounte; M-MaillCorrespondence <br /> O-Other Ek? Unit P-Phoc€ <br /> CC4PLUIl4T �iATiIS: Dt <br /> ................ <br /> oI-Field Abated 02-Office Abated 03-NAI Sent 04-Notice to abate Issued 05-Enforve ACT Initiated <br /> 05-7ransfer to Premise File 07-Refer to Other Agency 03-Not Valid 09-Foodborne Illness <br /> a PTOPriate Unit if conpiaint in anothtr PROCPAM jurisdiction, `lave Complaint Record and PIE updated <br /> Forwarded to UNIT: I II 111 iV for Investigation <br />