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Date rnn /10/21/93 SAN JOAQUIN COUNTY PUBLIC h2 PTH ERGIC Report <br /> : d�lU4 <br /> Run by As� CAROLINE Page � 1 , <br /> Capt # OJ OL NE COMPLAINT INVESTIGATION REPORT <br /> MMMhi!�fMMMAfI�fIrIMAfMMMhL�fMMi►�fhi�fhfMMMM���fl�fh�MMMMhLhfhlM��fMhlhiMMhihfMhffMMhi1►Lhfl�hlMM�1�1�L�fMMi�LnfMMMMMM � r <br /> COMPLAINT # .' 00000902 Program/Element 2500 , <br /> Tanen'I� t9l6 COL BORGRAR bate: 1Gj200" Assigned to : G?3i PhEIELA i'IOLETT' Gate: lfil2olQ' <br /> , <br /> Facility Name: Fac ID: <br /> BILL to inventoried FACiLiY: <br /> Location: 7707 N WEST LANE,. STOCKTON' Rust Dave FACILITY 1141 <br /> Complainant: <br /> <br /> <br /> FACILITY LOCATION/Property Info <br /> DBA or Name: BIG VALLEY DENTAL CENTER33 Loc Code 01 <br /> Address: 7707 N. WEST LADE BOS Dist <br /> City: STOCKTON APN : <br /> Phone: <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Dame: Home Phone: , <br /> Address: Work Phone: <br /> City: _ <br /> Natnre of Coaplaint: <br /> DR.WHO FORMERLY WKD FOR FACILITY OUT 3r/EPS'TEIN—BARK DISEASE—CAUSED F1 <br /> EXP TO TOLUENE,ALSO FND HI LEVELS OF MERCURY; MERCURY IS DUMPD INTO <br /> DRAINS & GARBAGE.FACILI'TIES USE INSECTICIDES AT THESE PREMISES — EMPLOYEE <br /> {COMPLAINANT)HIGHLY ALLERGIC TO INSECTICIDES, THEY ARE AWARE &. CONTINUE <br /> TO USE THEM. t I�� 01 <br /> Iner c&,fy/ IS <br /> tI J 0,1 <br /> SIDr✓l e.1 c�Srr�[ rt7 n ,11 <br /> 4-11 V1 sec. <br /> VVC;5%J SC <br /> COMPLAINT Info — <br /> E <br /> COMPLAINT K01IF1 P PEii;NE <br /> 1 V <br /> A-Agency Referral B-BD GF 4uYervisersjcity Gcouncil B-KaiilCerresgcndence } <br /> 0-Other ER hit. P-Pt.oLe <br /> i C4kiLAiliT `;Tk'3U3: .� ' <br /> 01-Field Abated , N-office Abated 03-NAE Sent 04-.Ne`ice to kbate is£ued 05-Fn[or— ACT initiated <br /> 06-Transfer to Praise Pile 0i-Eteier to 0#her hgency 034ot Valid O-Foodborne illness <br /> Circle aeproPriate Unit 4 if canplairt iu anaf� * PROORR.14 jarisdis`,ior., Bade Cospiaiat Record and PIKllpdated <br /> Forwarded to ilEil': i ;l 111 IV for investigation <br /> 19 <br />