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Date run : 07/20/96 SAN JOAQUIN COUNTY PUBLIC HEALTH 5ERViC RPM 4�1u4 <br /> 1;N1n._jb%,- : CAROLD, � Page # <br /> a* 1 <br /> Copy #" : 01 of 1 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # = C0010661 Program/Element 3612 <br /> Taken by : 7829 GAGAZA Date: 07/20/98 Assigned to 0740 ASKANAS Date: 07/20/98 <br /> Hard copy Printed: A <br /> Faci,l.i.ty Name : MEADOwG­R 5.N.-A,PARTMENT.S. Fac ID: 001.428 <br /> BILL to inventoried FACILITY: <br /> Location: 211 W SAN CARLOS WY (Must have FACILITY IDO <br /> Complainant: M.ICHELLE...._RAY�nsC3............#_S`........._....... _Home Phone: 209-476-9080 <br /> Address- ............................_........,...................._Wor k Phone <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name : N9EADQWGREEN....._AKARTM . BOS Dist <br /> City: STOCKTON, 95207 APN # <br /> Phone: 209-473--2421 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name . OCC_I_DENTAL....._CAPITAL_..,_HOLDING_5....._...............................__............._Home Phone : <br /> Address: 2454...........SAN......CARL©S .Work Phone : 51.0-885-1897 <br /> City: CASTR©._.._VALLEY. CA. 94546 <br /> a <br /> Nature of Complaint: <br /> POOL GREEN WATER . CHILD SICK HAD TO TAKE TO HOSPITAL . NO PUMP IN POOL . <br /> COMPLAINT Info - <br /> COMPLAINT MODE: P PHONE <br /> .................. <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: 06 <br /> 4 - 'eld Abated 02-_Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise 1 e 47-Refer to Other Agency 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: (11 11 III IV for Investigation <br />