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nate rWn. ZDRIN JURUUIN UUUN i r PUdLli- NtHL. f " i%tFV1L HDIV4 <br /> Run by' CARO LD/ Page # 3 <br /> Copy # 01 ©f 01 COMPLAINT INVESTIGATION REPORT <br /> COMPLAIN`1' # C0010860 Program/Element = 1625 <br /> Taken by : 6519 DISA Date: 08/20/48 Assigned to : 0740 ASKANAS Date: 08/20/98 <br /> Hard copy Printed: ' <br /> Facility Name: BURGER....._KING Fac ID: 002725. <br /> BILL to inventoried FACILITY: <br /> Location: 8023 WEST LANE (Must have FACILITY I0#) <br /> Complainant : ROSE ................ ............Home <br /> <br /> <br /> /Property Info - <br /> DBAor Name : BURGER K.I_NO..........._..._.. y_ _ _..._.........._..................._....._..........-....--._...._._.................-_..-.-.--_Loc Code : ©1.. <br /> Address: 8023 WEST LN 80S Dist : <br /> City: STOCK7ON, 95210 APN # <br /> Phone: 209-952-6595 <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name : WY MOND..s......_G_I_i-_......... <br /> ._......... <br /> _................._...._...._...._..._..._........................_................................._......._...._......Home Phone: 209-869-4581 <br /> Address: PO BOX....._380.. _..._._.... ._.-......._...._..............._... _............. <br /> .................................................. <br /> _....... <br /> Work Phone: 209-474-771.1 <br /> City: R,I_VERBANK CA 95367 <br /> Nature of Complaint: <br /> HAMBURGER STILL PINK IN MIDDLE . <br /> COMPLAINT Info - <br /> COMPLAINT MODE: P PHONE <br /> ................. <br /> A-Agency Referral B-8D OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> 0-Other £H Unit P-Phone <br /> COMPLAINT STATUS: <br /> 01-field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-TFan-s-fe-T-t-o--Pr-e-m-is-e-T-lTe- 7-Refer to Other Agency 08-Nat Valid 09-Foodborne Illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by: Date- <br /> Circle appropriate Unit A if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: O II III IV for Investigation <br />