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CO0008806
Environmental Health - Public
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1600 - Food Program
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CO0008806
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Entry Properties
Last modified
9/4/2020 3:55:34 PM
Creation date
2/11/2019 10:28:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0008806
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
8/12/1997 12:00:00 AM
SITE_LOCATION
4555 N PERSHING AVE
RECEIVED_DATE
8/12/1997 12:00:00 AM
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\P\PERSHING\4555\CO0008806.PDF
Tags
EHD - Public
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-,�,ni 'rlgn(_iTnl '�nt_!NT� 'LJEL 1,r_-;,j r, q?^crt 05104 <br /> �.. CARnI_D` <br /> � P a a'�. +1 <br /> 01 of 01 COMPI_!?INT INVESTIGATION REPORT <br /> COMPLAINT # = C0008806 Program/Element 1600 <br /> Taken by 3304 ARMSTRONG Date: 08/12/97 Assigned to : 0794 MATHEW Date: 08/12!97 <br /> Hard copy Printed: <br /> Facility Name ' ST OCKTC?N_..ROCKS Fac ID: 00464.1 <br /> RILL to inventoried FACILITY: <br /> Location' I-ITh'r1 ^. .iF (Must have FACILITY IDI). <br /> MHome Phone: <br /> Work Phone : <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name : STOCKTON R0CK5 Loc Code . 01., <br /> Address= 4555.... N....PERSH.1_NG._..AVE...____..._.__.............................:.__._... _ _. SOS Dist : 002. <br /> City ' STOCKTON 95207 APN # <br /> Phone : 209-952-1581 <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name , ` R..—Q... G..__INC_.........__....._...._. ............. <br /> ............... <br /> .._Home Phone: 209--474-0545 <br /> Address= 4.5.5.5_..N._._PERSH.I_NGAVE_#19 & 20....... .... ......Work Phone ' 209-952-1581 <br /> City - STQCKTON CA 95207 <br /> Mat�re ^` Camplaint� <br /> Orh:ROACr,E`_ IN PESTURANT . <br /> COMPLAINT Info — <br /> :OMPLAINT MCDE, PHONE <br /> A-Agency Referral 8-BD OF Supervisors/City CCOunCil C-Counter M-Mail/Correspondence <br /> P-Phone <br /> ...,MCI AT)4T ;T,� <br /> P.bate! 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> ; r,,-aofo. +o Other Agency 08-Not Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Letter Sent by ' _ Date' <br /> CirC!e appropriate Unit ! if complaint in another PROGRAM jurisdiction, Have Complaint Record and PIE updated <br /> F rward:a `o ' NIT Q II III IV for Investigation <br />
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