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CO0013003
Environmental Health - Public
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1600 - Food Program
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CO0013003
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Entry Properties
Last modified
9/4/2020 3:54:42 PM
Creation date
2/11/2019 10:28:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0013003
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
9/24/1999 12:00:00 AM
SITE_LOCATION
4555 N PERSHING AVE 16
RECEIVED_DATE
9/24/1999 12:00:00 AM
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\P\PERSHING\4555\CO0013003.PDF
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EHD - Public
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e curl� 0AQUI <br /> 09/30/99 SAN 3N COUNTY PUBLJ c- ��-��- <br /> -- Page # I <br /> a by CAROLD <br /> OMPLAINT INVESTIGATION REPORT NlMN1MM!`1N1NlMMN}M <br /> MMMMMMMMMMI"1MNfMNfMMNlNlMMMMMMMIv}N}Nfly}MMNIMMMMNl1Nll '�1 } MMM�6)19f M <br /> 01 of 01 C <br /> CMN}MNfMM <br /> program/Element <br /> PMPLAINT # = COO13003 <br /> aken by : 7801 HOLLINGSWORTH Date: 09/24/94 <br /> Assigned to : 0321 OLIVEIRA Date: 04/24/99 <br /> :lard copy printed: 09/30/99 F=ac ID : pp2514 <br /> Facility Name: RS.ZAN..-.5IJPRMARICT- BILL to inventoried FACILITY: <br /> (Must have FACILITY I00 <br /> Location= 455s.._.._iV......P RSH,TNG.....AV_::;: . _6.. <br /> Home Phone: 209-239-3014 <br /> ._ ......._.............._.- <br /> Complainant. CHAD.._._SANG ........._............-._........... .__. Work Phone: <br /> Address : ._...___._...... <br /> FACILITY LOCATION/Property Info — <br /> „_.. <br /> Loc Cods � 01.. <br /> DBA or Name: SSI.AN..__SUPERMARK...... ....._...._.._ ....�...._...................._BOS Dist _.......... <br /> Address; 4555...._ ....._P�RSH�NC__..AV ......1f? <br /> City: S;C_C3.CKT4N. 95207 <br /> Phone : 209-957--3097 <br /> BILLING RESPONSIBLE PARTY or OWNER Info — Home Phone : 209-952-`3548 <br /> Name: UNG...7....._AL, G_IA..................:__...._..................__........... ......._..............._..._........_ ......_.._..........._.............Wor k Phone: 209-957--3097 <br /> Address: 8667......M.A.R.NIRS......p_R_._#67 ............ ............ . . .... <br /> City: STQGKj_ON CA 95219 <br /> Nature of Complaint: <br /> EN TODAY AND IT WAS BURNED . COMPLAINANT AT <br /> BOUGHT YELLOW CURRY CHICK <br /> IT AND BECAME ILL_ ( VOMITING ) <br /> COMPLAINT. Info — <br /> COMPLAINT MODE: P.............PHONE <br /> A-Agency Referral B-BD OF Supervisors/City CCOUnCil C-Counter M-Mail/Correspondence <br /> 0-Other EH Unit P-Phone <br /> COMPLAINT STATUS: <br /> ield Abated 024ffice Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> Ob-T ansfer to Premise File 07-Refer to Other Agency 08-Not Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by : Date: .------ <br /> Circle appropriate Unit 4 if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I II III IV for Investigation <br />
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