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CO0001849
Environmental Health - Public
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1600 - Food Program
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CO0001849
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Entry Properties
Last modified
9/4/2020 3:54:47 PM
Creation date
2/11/2019 10:28:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0001849
PE
1619
FACILITY_ID
FA0002514
FACILITY_NAME
ASIAN SUPERMARKET
STREET_NUMBER
4555
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
ENTERED_DATE
5/12/1994 12:00:00 AM
SITE_LOCATION
4555 N PERSHING #14
RECEIVED_DATE
5/12/1994 12:00:00 AM
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\P\PERSHING\4555\CO0001849.PDF
Tags
EHD - Public
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.�----,� <br /> Date run: 05/13/94 SAN JOA.QUiN COUNTY PUBLIC HEALTH SERVIC Repor",trl#5104 <br /> Run by CAROLINE P a 5 <br /> copy n 01 of 01 COMPLAINT INVESTIGATION REPORT <br /> !f.M.Mhl.Mf�ti!MMMMMffMt�ryf!!MM6fMM.M.M.MMNMM..M.MM.M.MM.M.MfdMMfd.!!NM.... .MMM..MMM..MMM.MM..!.. .M.M.AO?!Att M.MMMattf�e�p <br /> f*MPLAINT S : 00001849 P.o9ram/Elemen : 1600 <br /> Taken by : 2115 CAROLINE NASCIMENTO Date: 05/12/94 A - gned to -7 _ R.ON ROWE Date: 05/12/94 <br /> Facility Name: ASIAN SUPERMARKET Fac 1514 <br /> BILL to inventoried FACILITY: <br /> Location: 4555 N PERSHING 014 (Must have FACILITY IDp) <br /> Complainant: ANNON.CUSTOMER Home Phone: G <br /> Address: Work Phone: <br /> FACILITY LOCATION/Property Info - <br /> DBP. or Name: 7'7-7 7 t&c Code 01 <br /> Address: 4555 N PERSHING BOB Dist 001 <br /> City: STOCKTON APN # <br /> Phone: <br /> BILLING RESPONSIBLE PARTY or OWNER Info - <br /> Name: Home Phone: <br /> Address: Work Phone: <br /> City: <br /> Nature of Complaint: <br /> SELLING FOOD THAT I5 OLD, BAD MEAT,VEGETABLES,ETC_COCKROACHES,FILTHY <br /> 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 /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: <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 OB-Not Valid 09-Foodborne Illness <br /> Circle appropriate Unit !t if compl/aiinntl in another PROGRAM jurisdiction, Have Complaint Record and PIE updated <br /> Forwarded to UNIT: J d / ri III IV for Investigation <br />
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