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Date run: 04/23/96 SAN JOAQUIN COUNTY PUBLICHEALTH SERVIC <br />Run by MARYCY, Report #W4 <br />Copy # 01 of 01 COMPLAINT INVESTIGATION REPORT page 4 <br />COMPLAINT # = 00005943 <br />Taken by : 0997 HARLIN KNOLL Otte: 04/23/96 Assigned p nt : 2546 <br />Hard copy Printed: to : 0997 04/23/96 <br />Facility Name: Fac ID: <br />Location: 321,2_ FWOosQ_N_.,_ -Al;NPO <br />complainant: <br />Address: <br />FILL to iflV#Rt,0T'ied FACILITY, <br />i MUSt hAVA f 6r T I T TV TA* I <br />FACILITY LOCATION/property Info — <br />DSA Or Name: <br />Address: <br />City: AC <br />,JwO 95220 <br />Phone. <br />Loc Code : <br />Dist : <br />APN # : <br />BILLING RESPONSIBLE PARTY or OWNER Info — <br />t,,4 am e * <br />Addr ess: __-Home Phone: <br />City. . .. .... Work Phone: <br />Nature of Coaplaint: <br />HK RESPONDED DRUG CHEMICALS. DUMPEO ON ROADSIDE CHP C-LOSED ROAD WHII-C, <br />LAIDLAW REMOVED WASTE EFOER DISPOSAL, SCENE CLEANED AND REOPENED A.I. <br />2'SO P.M. <br />COMPLAINT Info — <br />COMPLAINT MODE: P, _pHOME <br />,A-Agelcy Referral 8-8D OF Supervisors/City Ctouncil C -Counter M-MlillCorTespondente <br />O -Other EH Unit P -Phone <br />CWAINT STATUS: 01 <br />01 -Field Abated O2 -office Abated 03 -NA, Sent 04 -Notice to Abate Issued 05400tce ACT Initiated <br />06 -Transfer to Prolliss File 07-Aefer to other AgepCy 08 -Not Valid 09 -Foodborne illness <br />Circle aPPTOPtiltS Unit # if complaint in another PR06RAM jurisdiction, Have Complaint Record and P/E updated <br />Forwarded to UNIT: 1 11 (a IV for investigation <br />