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.� a <br /> Gate run:,e.04%01/96 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report 05104 <br /> Run by ' MARYO lc4o- Page # 2 <br /> Copy # = 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # = C0005797 . Program/Element : 1320 <br /> Taken by : 5756 ERNESTO JACOBO Date: 04/01/96 Assigned to : 5756 ERNESTO JACOBO Date: 04/01/96 <br /> Hard copy Printed: <br /> Facility Name : Fac ID : <br /> BILL to inventoried FACILITY: <br /> Location= 4835E AT ,_11TH S.T. (Must have FACILITY I0#) <br /> <br /> <br /> <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name : CONDONE.R......A.PT.S......... <br /> ...........__....... <br /> ...... <br /> .............................................................................._-...................................._......._._...Loc Cade = <br /> Address: 4835......E ...._._._1.1. ......5 ................................_.. BOS Dist : <br /> City: TRACY APN # <br /> Phone : <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name : THOMA _ <br /> S......BERT_RAM....... ....._MAh�.AGE .. <br /> R ._-_.,......1-1-.._.........................................-Home Phone <br /> <br /> <br /> .............................. ............ <br /> Nature of Complaint: <br /> SUBSTANDARD HOUSING — SEWAGE BACKING UP , ELECTRICAL HAZARDS . <br /> COMPLAINT Info — <br /> COMPLAINT MODE: O OTHER EH UNIT <br /> A-Agency Referral B-BO OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: O 3 <br /> -Field Abated 02-Office Abated 03- I Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> ransfer to Premise File 07-Re Other Agency 08-Not Valid 09-Foodborne Illness <br /> Circle appropriate Unit A if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: II III IV for Investigation <br />