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Date tan: 06124IY7 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Runt #5104 <br /> Ron by : KARENC� Page # 7 <br /> Cony # : 01 04 0'1 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # CO008475 Pnogna,m/ER eme-nt : 4000 <br /> Taken by : 9157 MARK BARCELLOS Date: 06/17/97 AAAtigned to : 9157Date: 06124/97 <br /> Nand copy <br /> Faci..Zity Name: Fac ID : <br /> BILL to Znventontied FACILITY: <br /> Loeati.on: 17576 RIVER ROAD IMuat leave FACILITY ID#J <br /> Comp2aLnant: JOE SMITH _Home Phone: 209-599-4576 <br /> Ad&L"A: U)onh Phone: <br /> FACILITY LOCATION/PLopen ty In4o - <br /> DBA on, Name: Loc Code : <br /> Add-PL"-6: - -- -- - - _ _130S Duet- : <br /> City: -- - -- --- - --- APN # <br /> Phone: <br /> BILLING RESPONSIBLE PARTY opt, OWNER In4o - <br /> Name: Home Phone: <br /> AddA"-� : - - -- — — — - -Home <br /> Phone: <br /> C�i..t y : — <br /> Nat"¢ 04 Comotad.nt: <br /> The chicken ma.nu Le � be-ting z paead b eh Lmd the ho"e and i--,, not b e-i.ng <br /> di-sked wi th-i..n 24 hocvc� . <br /> COMPLAINT In4o - <br /> COMPLAINT MODE: P PHONE <br /> A-Agwu Rebennat B-BD OF Supenud.bou/Cd,ty Ceo PmU C-Coan-ten M-Mad/Conneepoadeace <br /> 0-Otken EN UnA P-Pkone <br /> COMPLAINT STATUS: �. <br /> -fdetd Abat¢d 02-06bd.ee Abated 03-NAI Sent 04-Notice to Abate IAAaed 05-En4onee ACT I"ated <br /> en to Dn¢mim, Ftite 07-ReReA to Otken Agency 08-Not Vatd,d 09400dbovm IttuAA <br /> Send Re4 eAAxLt Letter. t-o <br /> Addhe 6-6: <br /> Reje.,Lc P. Letter Sen#. by : Date: <br /> Cd.nete appnopnd.ate Unet I d j comptad,nt dx anotkex PROGRAM ivaAdd.eti,on, Have Comptad.nt Reeotd and P/E updated <br /> Fonwanded to UNIT: O 11 111 IV ion Inuatd.gate.on <br />