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CO0006544
Environmental Health - Public
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1600 - Food Program
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CO0006544
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Entry Properties
Last modified
3/23/2021 10:55:34 AM
Creation date
2/8/2019 9:09:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0006544
PE
1617
FACILITY_ID
FA0003963
FACILITY_NAME
GRANT LINE BEACON
STREET_NUMBER
2420
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
ENTERED_DATE
7/25/1996 12:00:00 AM
SITE_LOCATION
2420 W GRANT LINE
RECEIVED_DATE
7/25/1996 12:00:00 AM
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\G\GRANT LINE\2420\CO0006544.PDF
Tags
EHD - Public
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Date run: 07/25/96 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 <br /> Run by : 01 ov(/ � // Page # 2 <br /> Copy # : O1 0 `aY COMPLAINT INVESTIGATION REPORT �Sy/�// <br /> COMPLAINT # : COOO6544 Program/Element : 1600 <br /> Taken by : 8714 MARY FRANKS Date:: 07/25%96-,� Assigned to 5756 ERNESTO 7ACOBO Date: 07/25/96 <br /> Hard copy Printed: <br /> Facility Name: D.IK._..._TRACY...._GAS.,_...&...._FOOD Fac ID: 003902, <br /> BILL to inventoried FACILITY: <br /> Location: 2420 W GRANT LINE (Must have FACILITY IDN) <br /> Complainant: ANDY ZARAKANI Home Phone : <br /> Address : Work Phone : <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: DIK TRACY GAS & FOOD Loc Code : 03 <br /> Address: 2420 W GRANT LINE BOS Dist <br /> City: TRACY, 95376 APN # <br /> Phone: 209-832-8273 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name : PADILLA� MI_LA , ,,,,,,,,,,,,, ,,, , .........Home Phone : 209-832-7780 <br /> Address : 17 ALMENDRAL AVE Work Phone: <br /> City : ATHERTON CA 94027 <br /> Nature of Complaint: <br /> SPOILED MILK SITTING IN PARKING LOT OF STORE . <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: _M6 <br /> 01-Field Abated 02-Office Abated 03-NAI Sent 04-No a to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 07-Refer to Other Agency 08- of Valid 09-foodborne Illness <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 />
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