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Date run: 03/19/96 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 <br /> Page # <br /> Run by MARYO� 1 <br /> Copy # 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # C0005713 Program/Element = 1600 <br /> Taken by : 0794 RAJU MATHEW Date: 03/18/96 Assigned to : 0794 R49_W++-V'Date: 03/18/96 <br /> Hard copy Printed: G <br /> Facility Name: LUCKY...MARKEw.T_ X3.09 Fac ID: 0.0.1. 09. <br /> BILL to inventoried FACILITY; <br /> Location: 3.6.3._6„_MARCH..,.,LANE, (Must have FACILITY IDA) <br /> Complainant: ATH.1_MA_-M.RAN._._..,__.,.;__....._......._.._......... ........ ...... ................Home Phone: 209-933.-3593 <br /> Address . ............... ..............................._.......:......._..........................................................................._Work Phone: <br /> FACILITY LOCATION/Property Info <br /> DESA or Name: LUCKY._"S....._#389_...._._................. .. ............................._.._.._Lnc Cade <br /> Address: 1.611.6 ........................................_._....................._..........................................................................._.................... <br /> BOS Dist' : <br /> City= S,T-0 APN # <br /> Phone, <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name: LUCKY.'..S....._5-10-RE I.N.0......................_........................................._..._...................._._................._.._Home Phone <br /> Address". <br /> <br /> Nature of Complaint: <br /> BECAME SICK WITH CRAMPS AFTER EATING SPINACH PURCHASED FROM LUCKY 'S ON <br /> 3/7/96 ALL THREE FAMILY MEMBERSE WHO ATE SPINACH BECAME SICK . <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <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 02-Office Abated 03-HAI Sent 04-Notice -te Issued 05-Enforce ACT Initiated <br /> 06-Transfer to premise File 07-Refer to Other Agency 08-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: IQ 11 111 IV for Investigation <br />