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Date run: 02/28194 SAN JOAQUIN COUNTY PUBLIC HEAiLTn b",V1- <br />Page !x 7 <br />Rdn by : SYLVIA - <br />* : 01 of 01 COMPLAINT INVESTIGATION REPORT <br />M �MMMMMMMMMM+slM+�MMM..... .MhTMM..lM?!Mh*MMMMM.M?!MM <br />MMMM+4MMMliM.Ml.MMtMM <br />.MMMAMMhIA <br />Program/Element ! 1500 <br />COMPLAINT! : CQ001495 nato. 0212@t9n <br />Taken by 7354 SYLVIA MARTINEZ Date: 02/28/94 Assigned to ; <br />Facility Name: LE SPUD Fac 10: 002908 <br />Location: 5308 PACIFIC AVE 0106 <br />SILL to inventoried FACILITY: <br />(Must have FACILITY ID#) <br />complainant: <br /> <br /> <br /> <br />FACILITY LOCATIONIproperty Info - <br />DBA or blame: L£ SPUD Loc Code 01 <br />Address: N308 PACIFIC AVE 0106 BOS Dist 002 <br />City: STOCKTON 95207 APN # <br />Phone: <br />BILLING RESPONSIBLE PARTY or OLS HER Info - <br />Name: LE SPUD Home Phone: <br />Address: 5308 PACIFIC AVE 0106 Work Phone: <br />City: <br />STOCKTON CA 95207 <br />Nature of Complaint: <br />- CHIPS HAD A DEAD -COCKROACH I" IT - <br />COMPLAINT Info -- <br />COMPLAINT MODE: P PHONE <br />A -Agency Referral B -BD OF Supervisors/City CCOuhcil C --Courter .4-Mail/Correspondence <br />O -Other EH Unit P -Phone <br />COMPLAINT STATUS: <br />C25- <br />01-F;o-ld Abated 02 -Office Abated 03 -NAI Sent 04 -Notice to Abate'Tsslued 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, HaSfe Complaint Record and P/E updated <br />Forwarded to UNIT: I II III IV for Investigation <br />