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Date, run: 01/03/9 . SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report 45104 <br /> Ruw by : CAROLD (ly Page # 2 <br /> Copy # : 01 of 1 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # : C0007437 Program/Element : 2200 <br /> Takes by : 1968 JERRY YOSHIOKA Date: 01/03/4 '7 Assigned to : 0418 MICHAEL KITH Date: 01/03/1 7 <br /> Hard copy printed: <br /> Facility Name; _ Fac ID: <br /> 1-410 BILL to inventoried FACILITY: <br /> Location; 741- AMERICAN (Must have FACILITY 104) <br /> <br /> <br /> FACILITY LOCATION/Property Info <br /> DBA or Name; Loc Code : <br /> Address: BOS Dist : <br /> City: _ APN # <br /> Phone: <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name: Home Phone: <br /> Address: Work Phone: <br /> City: <br /> Mature of Complaint: <br /> 10 TO 15 GALLONS OF GASOLINE RELEASED IN PARKING LOT . CONTAINDED AND <br /> PUBLIC WORKS CLEANED UP . <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 EN Unit P-Phone <br /> COMPLAINT STATUS: <br /> 01-field Abated 02-Office Abated 03-MAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 01-Refer to Other Agency 08-Mot Valid 09-Foodborne Illness <br /> Circle appropriate Unit 4 if complaint in another PROGRAM jurisdiction, Have Complaint Record and PIE updated <br /> Forwarded to UNIT: I II II IV for Investigation <br />