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CO0005983
Environmental Health - Public
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1600 - Food Program
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CO0005983
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Entry Properties
Last modified
8/6/2021 9:22:51 AM
Creation date
2/13/2019 12:59:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0005983
PE
1625
FACILITY_ID
FA0002462
FACILITY_NAME
EL POLLO LOCO #5893
STREET_NUMBER
678
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
ENTERED_DATE
4/30/1996 12:00:00 AM
SITE_LOCATION
678 N WILSON WAY
RECEIVED_DATE
4/30/1996 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\W\WILSON\678\CO0005983.PDF
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EHD - Public
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l <br /> ate run : 04/30/96 SANS l 'DAQUIN COUNTY PUBLIC HEAL_T - SERV IC Report 15104 <br /> Rum by z - MARYO "/ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> .. <br /> FACILITY LOCATION/Property Info - <br /> DBA or Name : E_L......PQL�L�O...._LOCO...#5893 _....... Loc Code : 0.1.. <br /> .. <br /> Address: 678...... <br /> ............N....._W_ILSON......WAY....... ... BOS Dist : OQ_l.. <br /> W_.......,..._ .........._........._..... <br /> City : STQ.CKTCIN. 95205 APN # <br /> Phone : 803--597-T8913 <br /> BILLING RESPONSIBLE PARTY or OWNER Info <br /> Name' ARMI=NTA-,_.R. .AF ASL............ Home Phone <br /> Address: 22.25 PLAA.....PARKWAY Work Phone : <br /> city : MOD_ESTO, CA. 95350 <br /> Nature of Complaint: <br /> DAVE , GIRLFRIEND AND HER DAUGHTER ATE AT EL POLLO LOCO BECAME SICK <br /> ALL THREE HAD RICE , CHICKEN , FRIEND AND HER DAUGHTERS WENT TO HOSP , <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> ................. <br /> A-Agency Referral 8-8D OF Supervisors/City Ccouncil C-Counter H-Mail/Correspondence <br /> 0-Other EH unit P-Phone <br /> COMPLAINT STATUS: <br /> u 01- ' bate -Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> enise File 07-Refer to Other Agency 08-Hot Valid 09-Foodborne Illness <br /> Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: [P II III IV for Investigation <br />
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