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i1 4 /wo <br /> SAN .7OAOt1TM r^ni J1\1TY PUBL.TC HEALTH SERVIC Report #5104 <br /> CAROL[ Page # 3 <br /> C,--)Py # 01 of COMPLAINT TNVESTTGATION REPORT <br /> COMPLAINT # : C0008597 Program/Element : 3600 <br /> Taken by : 9157 MARK BARCELLOS Date: 07/11/97 Assigned to 9157 MARK BARCELLOS Date: 07/11/97 <br /> Hard copy Printed: <br /> FacilitY Name: VENETIAN PARK APARTMENTS Fac ID : 001660 <br /> BILL to inventoried FACILITY: <br /> Location: 1540 MOSATC WAY (Must have FACILITY ID#) <br /> Cornu 1 a i na nt : ANONYOMt l; _ _ Home Phone: <br /> AddreSS7 Work Phone: <br /> FACILITY LOCATION/Property Info — <br /> nBA or Name : VFNETTAN PARK ,APARTMFNTS 1-oo Code '1 <br /> Addres=: = 1.540 MOSAIC WAY BOS [gist <br /> City : S-TOCKTON 95?07 APN # <br /> Phones ' ?1 -1--41 5?-9040 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name : JACOBSON,, NORMAN _ Home Phone : <br /> Address: <br /> <br /> Nature of Complaint: <br /> SWTMMTNG POOL HAS SHARP EDGES ON BOTTOM OF POOL.. . PEOPLE ARE CtJTTTNCzi <br /> THFTR FFFT ON SHARP ADGFS . <br /> COMPLAINT Tufo — <br /> A-4aency Refer-al P-Pn IF Ccouncil (.-Counter M-Mai PCorrespondence <br /> �_n1 hp(�• cN I-In i t C-Dhnna <br /> COMPLAINT STATUS, U <br /> O+-Field Abated n?-Office abated 03-NAI Sent o4-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 0A-Transfer to Premise silo o7-Refer to Other Aaency OB-Not Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by : Date : <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: 0 II III IV for Investigation <br />