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Date run: '06/24/401 <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 <br /> Rust by�r = CAROL© Page # 1 <br /> Copy # = 01 of COMPLAINT INVESTIGATION RE_'PORT <br /> COMPLAINT # = C0010487 Program/Element 1619 <br /> Taken by : 6519 DISA Date: 06/24/98 Assigned to : 0794 MATHEW Date: 06/24/98 <br /> Hard copy Printed: <br /> Facility Name : A5_IAN....._SUPE_RMARKET. Fac ID : 09.2.5-1.4. <br /> BILL to inventoried FACILITY. <br /> Location= 4555._..N...._PER SHING....._AUE....._1_b. (Must have FACILITY ID#) <br /> Complainant = ROES.ERT....._ EALZ_TE L ................ Home Phone= 209-952-8907 <br /> Address : Work Phone= <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: AS_T_AN....._ UPERMARKET......_......................................................_..... .. __. .... Lnc Code = 0.1- <br /> Address . 4555......N..._PERSH_T_NG...._AVE.......1_ ......:........._............................................................................_......_.............-8OS Dist : 4021 <br /> City= ST. <br /> QCKTQN. 95207 APN # <br /> Phone: 209-957-3097 <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name: UNG...r......_AL,.I_G.1_A..........................................................................................._....._..........._......._.......................Home Phone : 209-952-3508 <br /> Address. 866 . ..............._......................_............._...................................................................................... <br /> .......................... <br /> City - STOCKTON. CA 95219 <br /> Nature of Complaint: <br /> AREA WHERE MEAT IS CUT IS DIRTY <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-N to Issued 05-Enforce ACT Initiated <br /> 06-transfer to Premise File 07-Refer to Other Agenc 08-Not Vali 09-foodborne Illness <br /> Send Referral Letter to: <br /> Address= <br /> Referral Letter Sent by: Date: <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: 0—I <br /> II III IV for Investigation <br />