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�r?N J Onr)f I !rd your n' :lU! u i t; I It AI I I f I?V IC <br /> Run, 6y MARYO/C� Report N5104Page # 1 <br /> COPS it Ot of OI COMPLAINT INVESTIGArto rj !'I-FORT <br /> COMr't00006365 Pi Oji ani% "' .::went ; 4200 <br /> Taken by : 6519 CAROL DISH Date: 07/02/96 Assigned to 100+ %' ,: 07/02/96 <br /> Hard copy Printed: Cre7 01;tjey'L <br /> Facility Name: _ Fac ID: <br /> BI!i to inventoried FA( '! IIY: <br /> I n, A1 !on: 13`:% iS 6,! L.NUT' GROVE, a FACILITY 100 - <br /> ComPlair „nt : ROD GANSEN._, ANON YMnur; <br /> Address; me 7 <br /> I ,.,; "09- `34 .r I ! tt <br /> �� <br /> FAt,II.1 TY I OCATION/Pi o[.aerty Info <br /> DBA or Name: NEW HOPE LANDING Loc Code <br /> .....-.... <br /> elddtH.-3S: 13345 WALNUT GROVE fTOS Dist <br /> City: APN # <br /> TMORNTC)N <br /> Phone: <br /> BILLING RE SF'ttr., I81_F PARTY or OWNER T Ti Fo <br /> Namc- ���KER'T — ai✓ne-v home Phone: <br /> Addre b,4w,04,e M6�L .-_ Work Phouc,: <br /> City : <br /> Nature of CoaPlaint: <br /> OWNER HAS PUI IN SEPTICS , I.FACH LINK :; afa UND[ I: I.!I, II i , .. COMPLATNT:' NT <br /> DUBS NOT BF-I fF1VCC HE HAS PFRMITS . <br /> l 1� <br /> COMPLATNT Info <br /> COM,'I AIN: MOL: NONE <br /> PRONE <br /> A-Agency Referral B-BD OF ',ors/City Ccouecil C-Countri ” <br /> 0 rrEli Unit P-Phone <br /> COMPLAINT STATUS DV <br /> C <br /> 01-field Abated 02-Office Ahmed 03-NAI Sent 04-Notice to Ahe',e Irr„ural 05 lofotce ACT Initiated <br /> �,-Ii.ni8f131 P . (` gyp r3r: I lio Ji "r r'•: L. i� srgfy 9'd i;m Valid 09-roodborne Illness - <br /> Circle appropriate Unit R if complaiel in anr.i' ^RODRAM juri6a ion, Have coo:plaint Record and P/E updated <br /> Forwarded to UNIT: II[ IV for investigation <br /> II <br />