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CO0007171
Environmental Health - Public
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1600 - Food Program
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CO0007171
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Entry Properties
Last modified
9/4/2020 3:55:34 PM
Creation date
2/11/2019 10:28:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0007171
PE
1625
FACILITY_ID
FA0004641
FACILITY_NAME
STOCKTON ROCKS
STREET_NUMBER
4555
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
ENTERED_DATE
11/4/1996 12:00:00 AM
SITE_LOCATION
4555 N PERSHING AVE
RECEIVED_DATE
11/4/1996 12:00:00 AM
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\P\PERSHING\4555\CO0007171.PDF
Tags
EHD - Public
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Date run: 11/05/9 SAN JOAQUIN .COUNTY PUBLIC HEALTH SI=RVIC Report 15104 <br /> Run by : CAROLD Page #k 1 <br /> Copy # R : 01 of 1 COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # = C0007171 Pro r ement 1600 <br /> Taken by : 8714 MARY FRANKS Data: 11/04/96 Assigned to 0 H "'IN Date: 11/04/96 <br /> Yard copy PYinted: 11/04/96 <br /> .-Facility Name: STOCKTON „.R_0,,.,CKS Fac ID: 641 <br /> ...................._. <br /> BILL to inventoried FACILITY: <br /> Location= 4555_„__,,,_N,„WPER HI_N..... _AVE, {Must have FACILITY ID#} <br /> Cofnpla,i-rant: . MARYF'RANKSTHome-Phone; 209-468-3427 <br /> Address: ........... am k 2l ne <br /> FACILITY LOCATION/Property Info — <br /> D84 or Name: STQCKTQN_...R0CK5........................._..... Loc Code : Q1.. <br /> .. _..._......._..............._......_.. .. _... <br /> Address: 4855.----NPERSHING AVE _ BOS Dist 002 <br /> 'City: . ............................ <br /> ST©CKTON 95207 APN # : <br /> Phone : 209-952-1581 <br /> 81"I:NG RESPONSIBLE PARTY or OWNER Info <br /> Name: S.._.:R.__B_.._G..._..INC.....____................_.................................._............. --.-......................................_..._Home Phone: 209-474-0545 <br /> Address: 4555,__N PE~RSHING.. .AVE #-19 _&....._20....._........._...._._.__._._._..-_Work Phone: <br /> City= SOCKTQN CA, 95207 <br /> Nature of Complaint-: <br /> • SAT 11-02—% SINK & TOILETS IN LADIES ROOM OVER FLOWING & BACKED UP <br /> COMPLAINT Info — <br /> COMPLAINT MODE: <br /> A-Agency Referral A-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: <br /> 01-Field Abated 02-Office Abated 03-NAI Sent 04-N ' sued 05-Enforce ACT Initiated <br /> 06-Transfer to Premise File 07-Refer to Other Agency Not Valid 09-Foodborne Illness <br /> Circle appropriate Unit I if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: (1 II III IV for Investigation <br /> i <br />
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