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Date rU6: 01/15/9( AN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Rpage eport IJ04 1 un b4 COMPLAINT INVESTIGATION REPORT COMPLAINT # = C0007485 Program/Element : 1600 Taken by : 9051 NARY OSULLIVAN Date: 01/15/97 Assigned to : 5756 ERNESTO 3ACOBO Date- 01/15/97 Hard copy Printed: Facility Name: BIG,_,_VALLEY,„_F FOOD Fac ID= 001895, BILL to inventoried FACILITY: Location 1.832._...,,,,„MT,_,__D_I_ABLO....._AVE. (Aust have FACILITY IDI) FACILITY LOCATION/Property Info — Loc Code : 01., DBAor Name BIG VALLEY -FOOD Y......FOOD....._......_........._...._.........._..............................._...._....._._............,..............................................._._.__... Address: 1.832.......... MT...._D_I_ABLn,..,.,AVE-......................___..........................._......................_._.................._.................................845 Dist = City- STOCKTON, 95203 APN # Phone: 209--465--3100 BILLING RESPONSIBLE PARTY or OWNER Info — Name : LIN, TSE,.:..___CHOW_:......-WONG..s.......CEN._&H_I_N............_.........._............Home Phone= Address= 1.832.._...._.MT....._DI.ABLO......ME—.............................._................................................_..._.__..........._Work Phone City: STOCKTON, CA, 95203 Nature of ComPlaint: FOR OVER A YEAR HE HAS BEEN SHOPPING AT ABOVE ADDRESS ,. THE PLACE HAS A TERRIBLE ODOR , ROTTEN MEAT , ROACHES AND IS A MESS . COMPLAINT Info — COMPLAINT NODE: P PHONE A-Agency Referral B-BD OF Supervisors/City CCOUnCil C-Counter M-Mail/Correspondence 0-Other EH Unit P-Phone COMPLAINT STATUS: 01-Field Abated 02-Office Abated 03-NAI Sent 04-Notissued 05-Enforce ACT Initiated 06-Tr8n8fer to Premise File 07-Refer to Other Agency 8-Not Valid 09-Foodborne Illness Circle appropriate Unit 4 if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated Forwarded to UNIT: (I II 111 IV for Investigation