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CO0003017
Environmental Health - Public
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1600 - Food Program
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CO0003017
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Last modified
8/6/2021 9:23:08 AM
Creation date
2/13/2019 12:58:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0003017
PE
1618
FACILITY_ID
FA0002468
FACILITY_NAME
WALGREENS
STREET_NUMBER
678
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
ENTERED_DATE
12/8/1994 12:00:00 AM
SITE_LOCATION
678 N WILSON WAY #15
RECEIVED_DATE
12/7/1994 12:00:00 AM
P_LOCATION
01
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\W\WILSON\678\CO0003017.PDF
Tags
EHD - Public
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Date run: 12/08/94 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Paogte#5#O4 12 i <br /> Run by : CAROLINE/6P. <br /> Copy # : 01 of 01 COMPLAINT INVESTIGATION REPORT 1 <br /> II <br /> COMPLAINT # C0003017 Program/Element • 1300 I <br /> Taken by : 0740 BRUCE ASI;ANAS Date: 12/07/94 Assigned to : 0740 BRUCE ASIIANAS Date; 12/07/94 1 <br /> Bard copy Printed: I <br /> Facility Name: WALGREENS Fac ID: 002468 I <br /> BILL to inventoried FACILITY: I <br /> Location: 678 N WILSON WAY #15 ��� (Must have FACILITY IDS) <br /> I <br />� Complainant : <br /> : <br /> 7 — � <br /> I <br /> f FACILITY LOCATION/Property Info -- <br /> I DSA of Name: Loc Code : <br /> I Address : BOS Dist <br /> I f City: _ APN # <br /> Phone: <br /> I BILLING RESPONSIBLE PARTY or OWNER Info — <br /> i Home Phone: <br /> Name: <br /> f Address : Work Phone: <br /> City: <br /> I Nature of Colplaint: <br /> "VERO" CANDY W/LEAD CONTAMINATION AT FACILITY` <br /> t <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> l <br /> I COMPLAINT Info — <br /> I COMPLAINT MODE: 0 OTHER EH UNIT <br /> I <br /> I A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correspondence <br /> 0-Other RH Unit P-Phone <br /> I COMPLAINT STATUS: <br /> I <br /> I 01-Field Abated 02-011ice Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> 06-Transfer to Prexise File 07-Refer to Other Agency 08-)tot Valid 09-Foodborne Illness <br /> I <br /> { <br /> i <br /> i <br /> I <br /> I Circle appropriate Unit 0 it coyplaint in another PROGRAM jurisdiction, Have Co®plaint Re.eord and P/E updated <br /> Forwarded to UNIT: II III IV for Investigation <br /> I <br /> I <br /> I <br /> I <br />
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