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Date 7-un : 04/29/`07 SAN JOAQUIN COl1NTY PUBL- IC HFAI-TH <,FP1'TC Report #5104 <br /> Run by = KAREN Pape # 1 <br /> Copy # = 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # : C0008104 Program/Element : 1&eo- L� <br /> Taken by : 3304 KAREN ARMSTRONG Date: 04/29/97 Assigned to : 9157 MARK BARCELLOS Date: 04/29/97 <br /> Hard copy Printed: <br /> Far,i l :i t v Name= : tJJCKY DISCOUNT CENTER MKT #186 Fac ID: 000833 <br /> BILL to inventoried FACILITY: <br /> Location: 11? N MATN QTRFFr MANTF(-A (Must have FACILITY ID#) <br /> Complainant : PAMULA PANGHome Phone : 209-82.3--5500 <br /> ................ <br /> Address: Work Phone: 209-82.3-5500 <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: l.oc Code : <br /> Address: BOS Dist : <br /> City: APN # : <br /> Phone: <br /> BILLING RESPONSIBLE PARTY or OWNER Info - <br /> N,-.4me= Home Phone: <br /> Address= Work Phone : <br /> City , <br /> Nature of Complaint: <br /> Her datiahter was ill with food noi=:oning caused by meat ( turkey breast <br /> meat ) purchased from the deli . Please call the compl.aintant as soon as <br /> possible . <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: Or <br /> 01-field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 07-Refer to Other Agency 08-Not Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by : Date: _...- <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: O II III IV for Investigation <br />