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Da#e` run: 05/13/9/7�SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 <br /> WA <br /> Run by REN`yo Page # 15 <br /> Copy #, 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee <br /> COMPLAINT # C0008209 Program/Element : 4300 <br /> Taken by : 0467 JEFF CARRUESCO Date: 05/12/97 Assigned to 0467 JEFF CARRUESCO Date: 05/12/97 <br /> Hard copy Printed: 05/13/97 <br /> Facility Name: _ Fac ID: <br /> BILL to inventoried FACILITY: <br /> Location: 10 W. MOSSDALE (Must have FACILITY ID#) <br /> Complainant : EILEEN Home Phone: 209-601-0891 <br /> Address : Work Phone: <br /> FACILITY LOCATION/Property Info - <br /> DBA or Name : Loc Code : <br /> Address : BOS Dist : <br /> city: _ APN ## <br /> Phone : <br /> BILLING RESPONSIBLE PARTY or OWNER Info - <br /> Name : Home Phone: <br /> Address : Work Phone: <br /> City. _ <br /> Nature of Complaint: <br /> Requesting a well test . On 5/5/97 a sample was taken by Jeff Carruesco <br /> and tested negative. <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-NAI 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 /> 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: I ]I 111 IV for Investigation <br />