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Date rune 09/03.96 SAN JOAQUIN COUNTY PUBLIC HEALTH SE.RVIC Report 15104 <br /> kun by MARYF� 1 <br /> Copy # : O1 of 0 COMPLAINT TNVESTIGATTON REPORT Page # <br /> COMPLAINT # = COOO68O5 Program/Element : 2300 <br /> Taken by : 0997 HARLIN KNOLL Date: 08/29/96 Assigned to 0997 HARM NOLL Date: 08/29/96 <br /> Hard copy Printed: 09/03/96 15v h <br /> Facility Name: Fac ID: <br /> BILL to inventoried FACILITY: <br /> Location: 6550 E . HWY 12—LOCI_ (Must have FACILITY 101) <br /> Complainant : Home Phone : <br /> Address : Work Phone : <br /> FACILITY LOCATION/Property Info — <br /> DBA or Name: Loc Code <br /> Address : BOS Dist <br /> City APN # <br /> Phone : <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name : NUSRAT MALIK Home Phone: <br /> Address : P .O . BOX 7432 Work Phone: <br /> .......... <br /> . ... ... <br /> City : SHAWNEE MISSION KS 66207-432 <br /> Nature of Complaint: <br /> POSSIBLE UST LOCATED NORTH SIDE OF CINDER BLOCK SHOP . <br /> COMPLAINT Info — <br /> COMPLAINT MODE: 0 OTHER EH UNIT <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 /> O1-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 08-Not Valid 09-Foodborne Illness <br /> Circle appropriate Unit 1 if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I II G <br /> IV for Investigation <br />