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CO0004447
Environmental Health - Public
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MONTE DIABLO
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1832
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1600 - Food Program
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CO0004447
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Last modified
4/22/2024 9:45:23 AM
Creation date
2/8/2019 11:41:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0004447
PE
1617
FACILITY_ID
FA0001895
FACILITY_NAME
BIG VALLEY FOOD
STREET_NUMBER
1832
STREET_NAME
MONTE DIABLO
City
STOCKTON
Zip
95203
APN
13341135
ENTERED_DATE
8/15/1995 12:00:00 AM
SITE_LOCATION
1832 MONTE DIABLO
RECEIVED_DATE
8/15/1995 12:00:00 AM
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\bmascaro
Supplemental fields
FilePath
\MIGRATIONS\M\MONTE DIABLO\1832\CO0004447.PDF
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EHD - Public
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nat-e rup a-oe/15 95 -AN TOAOI IN COUNTY -PUHLTC HEALTH 5EHVIl - ntpUtl, VjLV, I <br /> A&.�n by SHELL'f! page �k <br /> `,`" `,` 01 of 01 C0MPLAINT If�',IESTTGATTi�N REPORT <br /> COMPLAINT # _=C0004447 Program/Element : 1600 <br /> Taken by : 9051 MARY OSULLIVAN Date: 08/15/95 Assigred to : 0794 RAJU MATHEW Date: 08/15195 <br /> Hard copy Printed: <br /> Facility Name: B1.G..._;JA LE'f.. F.00D. Fac ID - 00.1895 <br /> aILL to inventoried FACILITY: <br /> Location-- 163_2 MT DT ARLfl (Mast have FACILITY IDS} <br /> <br /> ' <br /> FACILITY LOCATION/ProPeTtY• Info — <br /> DESA or Name- BIG VALLEY f00D„ .. Lac Code : 01 <br /> Address : 1832 MT_ DIABLO SOS Dist <br /> Cite- TOQKTON 952,03 APN #T <br /> Phone : 209-465--3100 <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name' LI.N..,. _T-SE.. ..._�:.How.,....WQNC _...CEN,CHIN <br /> Home Phone' <br /> Addres 832........MT__[) 1 0. ....-.. Work Phone ' <br /> ......... <br /> city -, STQ_CKTON CA 95203 <br /> Nature of Complaint: <br /> EMPLOYEE KILLED A FLY THEN PICKED IT UP WITH HIS HANDS . PROCEEDED TO <br /> SERVE A POUND OF WITH THE SAME HAND THAT HE KILLED THE FLY WITH <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> A-Agency Referral B-SD OF Supervisors/City Ccouncil C-Ccunter M-Mail/Correspondvice <br /> O-Other EH Upit P-Phorle <br /> COMPLAINT STATUS' 0%,", <br /> 01-Field Abated 02-Office Abated 03-NAI Sent, 04-ho`5p�e to Abate Issued - 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 07-Refer to Other agency 08 Not Valid 04-Foodborne illness <br /> Circle appropriate Unit k if complaint in another PROGRAM jurisdiction, Have Complaint Record and ?/E updated <br /> FarWarded to UNIT: IT !II IV for Investigation <br />
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