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Uare run: vili f/y4 5AM JUAQUIN CUUNTY PUiLIG "F-ALI" SERV G lmeporr *51V4 <br />Run by : SYLVIA Page 0 1 <br />Copy 0 01 of 01 COMPLAINT INVESTIGATION REPORT <br />AfMM1 TIMI E!l�IMMMINM�►ArIMMINMMMAIMFfi�! <br />WMPLAINT • : 00001566 Program/Element : 1800 <br />`-�- Taken by : 2115 CAROLINE NASCIMENTO Date: 03/17/94 Assigned to : 0102 STEVE MINDT Date: 03/17/94 <br />Facility Name: LA BOULANGERIE Fac ID: 002905 <br />BILL to inventoried FACILITY: <br />Location: 5308 PACIFIC AVE (Must have FACILITY ID#) / <br />Complainant: <br /> <br />FACILITY LOCATION/Property Into <br />DBA or Name: <br />LA BOULANGERIE <br />Loc Code 01 <br />Address: <br />5305 PACIFIC AVE <br />BOB Dist 002 <br />_ _ <br />City: <br />STOCKTON 95207 <br />APN 9 <br />Phone: <br />209-474-0424 <br />BILLING RESPONSIBLE PARTY or OMER Into - <br />~ <br />Name: <br />RAYMOND BITAR <br />Home Phone: <br />Address: <br />5308 PACIFIC AVE <br />Work Phone: 209-474-0424 <br />City: <br />STOCKTON CA 95207 <br />Nature of Complaint: <br />- BOUGHT DAUGHTER A MILK IT WAS OUT OF DATE OVER A WEEK - SOUR - ALSO <br />WARM - HE ADVISED PROPRIETOR - DAUGHTER BECAME ILL COMA PIAIFIANT WANTS <br />TO BE INFORMED OF RESULTS <br />COMPLAINT Info - <br />COMPLAINT MODE: P PHONE <br />A -Agency Referral B -BD OF Supervisors/City Ccouncil C -Counter N-Mail/Correspondence <br />O -Other EH Unit P -Phone <br />r <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 />Circle appropriate Unit K if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br />Forwarded to UNIT: I II III IV for Investigation <br />