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Date run: 10/05/998 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC � Report #5104 <br /> Run by : CAROLD Page ## 1 <br /> Copy # : 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> MP�JMMMNfNIE"!P!1 YMP7Nff�lMl h7MMMNfMMMMNIMMMMMMMMP11�lMMMI~fMMMMMMP'}NJNff`JMMMMMMMMMNJMMMMf,IhJMf"frJMrilylfvJ.MMMMNJM <br /> COMPLAINT # = C0013074 Program/Element : -1,2eV. ' <br /> Taken by : 5366 LINEBAUGH Date: t 5 9 Assigned to 5366 LINEBAUGN Date: 10/05/49 <br /> Hard copy Printed: l 7 <br /> Facility Name: ac ID : ! <br /> BILL to inventoried FACILITY: <br /> Location: 30.09.,_..S.,.__POCK......L'N (Must have FACILITY I00) <br /> Complainant: <br /> Address: <br /> FACILITY LOCATION/Property Info - <br /> DBA or Name: Loc Code_ : <br /> ................._....._................................_ ............... _._.................._. <br /> Address : 34a9 ._ <br /> .... S,... POCK....._L.N._................................... ........................_................................:,..........._................_BOS. Dist <br /> City- S-OCKTON, APN # <br /> Phone : <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name". __ Phone: <br /> Address : Work Phone : <br /> City - ............ <br /> Nature of Complaint: <br /> OPEN , UNSECURED SFD AND BASEMENT . <br /> COMPLAINT Info <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: . <br /> 01-Field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05 Enforce ACT Initiated <br /> Ob-Transfer to Premise File 07-Refer to Other Agency 06-Not Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by : Hate= _ <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and PIE updated <br /> Forwarded to UNIT: II III IV for Investigation <br />