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I s ' 4 �; � JJFiUU-1N .:uJ>ITY PUBLIC HEPL.TH WER�JIr. Report #5104 <br /> ply <br /> Ru n CAROLD 1 <br /> copy, 9 � O1 o�F �1 COMPLAIN'T INVESTIGATION REPORT Page # <br /> COMPLAINT # C0009067 Program/Element : 2546 <br /> Take:i by : 3973 MCCLELLON Date: 09/24/97 Assigned to : 3973 MCCLELLON Date: 09/24/97 <br /> Hard copy Printed: <br /> F ,Ae i l i ty Name : Fac TD- <br /> BILL to inventoried FACILITY: <br /> Location C.ORNE;�- 7F;SAN-.A PAULA & Mt DUFF A,V, (Must haus FACILITY IDt) <br /> Complainant ; <br /> ; <br /> FAC-'rLrTY LOCATION/Property Info — <br /> CBA or Name, Loc Code : <br /> - ................... <br /> Address- BBS Dist : <br /> - _.._....... <br /> .............. - <br /> City ; APN $k <br /> Phone <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name : Home Phone: <br /> Addres:n . Work Phone : <br /> - ...................._.._................_......._..... .....__..._._.............._...._............_..-------- <br /> City <br /> Nature of Complaint: <br /> 2 QUARTS OF OIL . <br /> COMPLAINT Info — <br /> COMPLAINT K DE r PHONE <br /> A-Agency Referral 10-ED OF Supervisors/City Ccouncil C-COunter M-Mail/COrrespondence <br /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS:(- <br /> 1 <br /> TATUS:(' ',2-office i�� <br /> 3-NAI Sent 04-Notice to Abate Issuad 05-Enforce ACT Initiated <br /> Premise Fi e to Other Agency 08-Not Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address= <br /> RG F- s i al Lwt.ler sent by : Date : <br /> :hole appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> FoTFa'ded t: „NIT, II Q IV for Investigation <br />