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Late run : 02/07/95 SAN JOAQUIN COUNTY PUBLIC: HEALTH SERVIC Report #5104 <br /> Run by CAROLINE/Gr.;_ <br /> Copy 01 of 01 COMPLAINT INVESTIGATION REPORT Page if 1 <br /> COMPLAINT # - C0003289 Program/Element = 1600 <br /> Taken by : 2115 CAROLLNE NASCIMENTO Date: 02/06/95 Assigned to (�NV Date: 02/06/95 <br /> Hard copy Printed: <br /> Facility Name. PAP CI.TO ME=XICAN_ GRILL &- BAR, Fac Ib ; OO2Q8� <br /> ............_....- <br /> Location= 29 ErMARCH.....LN BILL to inventoried FACILITY: <br /> ... . (Must have FACILITY ID#) <br /> Ccamplainant = <br /> ': <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name. PRPACITOS.._...... . ... Lac Code : 01 <br /> 29 <br /> ...... .._........ <br /> Address= E MARCH LANE... .. <br /> -11. ...... ....... BOS Dist 002 <br /> City: aTOCKTON. 95207 APN # <br /> Phone= 209,-951--4100 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name; 7AR5EEH SHARMA ._................... <br /> ..Home Phony; <br /> Address : 29 E MARCH LANA....... .....Work Phone: 209-951-4100 <br /> City: S�OCKT01� C,A 95207 <br /> Nature of Complaint: <br /> gN 2./4/95 ;CMPLNT & MOTHER HAD DINNER ,MOTHER HAD PAPACITO TOSTADO ,NO <br /> SALSA OR CHIPS & WATER , CMPLNT HAD SHRIMP ENCH LIDA ,BEANS ,RICE ,SALSA &- <br /> CHIPS/WTR;fMOTHER BECAME ILL NeXT DAY ABOUT 4M/CALL CMPLNT AFTER INSPECT . <br /> ( CMPLNT FEELS MOTHER BECAME_ ILL FROM THEM TOSTADA ) <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> ................. <br /> A-Agency Referral li-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: G'r <br /> 01-Field Abated 02-Office Abated 03-HAI Sent 04-Notice to Abate 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 FIE updated <br /> .Forwarded to UNIT: II III IV for Investigation <br />