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Date run: 11/17/93 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report 05104 <br /> Run by SYLVIA Page 0 3 <br /> Copy rs : 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> MP4MliM1•lhfAiflM1dMMMMI�fMMAfiyIMMMPdMhfMhfh!llR7l.4Mh41dP•1Mh4h1hlhfMMf 1Mh41d11I•fh4FlMhlM!fM1d1IMMM1lMMMA•f1dMMMMf9Mdff�iMMl•!M <br /> COMPLAINT S : GOOOIO63 Program/Element : 1300 <br /> Taken by : 7354 SYLVIA MARTINEZ Date: 14/17/33 Assigned to 0369 JALANE RIHANN pate: 11/17/93 <br /> Facility Name: Fac ID: <br /> BILL to inventoried FA <br /> Location: 314 5 VENTURA (Rust have FACILITY 11 <br /> Complainant: <br /> <br /> FACILITY LOCATION/Property Info - <br /> DBA or Name: WILLIE BELL Lac Code 01 <br /> Address: 314 S VENTURA BOS Dist 001 <br /> City: STOCKTON 95243 APH 0 <br /> Phone: <br />` BILLING RESPONSIBLE PARTY or OWNER Info - <br /> Name; BURLEIGH H & W HARRISON dome Phone: <br /> Address: 1810 S MONROE ST Work Phone: <br /> City: STOCKTON CA 25206 <br /> Nature of Complaint: <br /> - SUBSTANDARD - <br /> x <br /> COMPLAINT Info - <br /> COMPLAINT MODE: 0 OTHER EH UNIT <br /> A-Agency Referral B-80 OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> O-Other Unit P-Phone <br /> COMPLAINT STATUS. CJ J 0 J" <br /> 7( s <br /> E <br /> 01-Field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiates! <br /> O6-Transfer to Premise File 07-Refer to Other Agency 08-Nat Valid 09-Foodborne Illness <br /> Circle appropriate Unit G if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I II III IV for Investigation <br />