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Da�e run � O4/18 SAN J0AQUIN COUNTY PUBLIC HEALTH SERVIC Report #6104 <br /> Run by KAREN Page � l <br /> Copy # ' 01 of 01- r0MPLAINT TNVEcTTGATT0N REPORT <br /> COMPLAINT C0008016 Proqram/Element : 2400 <br /> Taken by : 3304 KAREN ARMSTRONG Date: 04/16/97 Assigned to : 0626 HECTOR CASTRO Date: 04/16/97 <br /> Hard oovy Printed: 04/17/07 <br /> Facility Name : DELTA HOTEL Fac ID: 00154l <br /> 8Dl to inventoried FACILITY: <br /> Location: 241 |N '-5 (Hut have FACILITY 0W)AN }U��UI� o <br /> Complainant -- SHTRLEY 0VERSTREET � �Home Phone: <br /> Address: DELTA_H0TEL .ROOM ]. _- ..... Work Phone - <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name : __Loc Code : <br /> Address : �� ' - �__-BO5 Diet � <br /> City : .��� r �� ���� �z�� ��_ APN # � <br /> Phone : <br /> BILLING RESPOnf — <br /> Name : Home Phone : <br /> Address : Work Phone: <br /> City , J��^.Vc ~V -.;t ~ <br /> Nature of Complaint: <br /> SUBSTANDARD HOTEL . <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> A'AVwmy Referral B-BD OF 6uPorvixom/Citv CoounoU C-Counto/ M-Hail/Corrnonondooce <br /> O'0thor EH Unit P'Phvno <br /> COMPLAINT STATUS: 01:11r-1 <br /> O1-Field Abated 02'0ffioo Abated 03'NAI Sent 04-Notice to Abate lxouod OS'Enfo/oo ACT initiated <br /> 06-lmnofor to Premise File 07-Refe/ to Other A000cv 00'Nvt Valid 09-Foodborne li\noxn <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter 9ent hv � Date � _______________ _ <br /> Circle apomvriatv Unit # if complaint in another PROGRAM Jurisdiction, Have Complaint Record and P/E undated <br /> Forwarded to UNIT: 0 11 111 IV for Investigation <br />