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Date run: 11/09/93 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report 151H <br /> Run by CAROLINE Page 4 1 ly <br /> 01 of 01 COMPLAINT NliE T _GATION REPORT <br /> MILm KvM1W,�f► M1►fA1MM.>IhL'�LtlhLh' �..L ��h.rel;ll�i.+�f 111f_L�L�►111L�flkfr}ZhZ1fAfI11!f LhlhihlhLhl MMM i1�f.�lhfi 1 L�111I.'�1M.f <br /> COMPLAINT # COOO1006 Program/Element : 2500 <br /> Waken by : 9905 NA11 EIUSOF, Gate: 1:1'09]94 Allik: tc '.409192 <br /> Facility Name: STOCKTON INN Fac ID: 002187 <br /> Bi LL to invetEtoried FACILIT't: <br /> Location.: 4219 E WATERLOO RD !Dust have FACILITY ibl' ---- � <br /> Complainant: <br /> <br /> FACILITY LOCATION/Property Info - <br /> DBA or Dame: Stockton Inn Loc Code 99 <br /> Address: 4219 Waterloo BO5 Dist <br /> City: , Stockton 95205 APIA <br /> Phone: <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name. Dawe Anley, Home Phone: <br /> Address: 4219 Waterloo Road Rork Phone: 209-931-3131 <br /> City: Stockton CA 95205 <br /> Pature of Complaint: <br /> Case OSN-93-130—Rm#155—Contaminated due to drug lab—mgr needs guidance <br /> as what to do-room is sealed. <br /> COMPLAINT Info — <br /> COYIPLALNT RODE: A AGENtiY REFhR?kL <br /> A-Agency Referral B-BD O? Supen iscrs/City Ccouncil C-Counter X-Mai`/Correspond ence <br /> G-other E1 'hiit P-Phone <br /> COMPLAINT STATUS: DI <br /> 01-Field ,Abated 02-Office Abated 02-NAI Sent H-Nctice to Abate issued H-Eriforse ACT initiated <br /> H-Transfer to Precise Fiie 0-Refer to Other-heeny 0E-Not Valid 59-Foodborne Illness <br /> Circle appropriate unit 1 if coop hint in another PROGRRN .jurisdiction; Katie ftmplaint Record and AIR undated <br /> Forwarded to UN.11: I 11 ill I9 for :r;vestigation <br />