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Date run: 12/14/98 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Revort #51f}4 <br /> Run by : DENORA Page # 2 <br /> Copy # : 01 of COMPLAINT INVESTIGATION REPORT <br /> COMPLAINT # = C0011392 Program/Element `: _ <br /> Taken by : 7829 GAGAZA Date: 12/14/98 Assigned to : 03rs4�E, ,NN Date: 12/14/98: <br /> Hard copy Printed: _PZaZ <br /> Facility Name : wAL-GREENS. Fac ID: 40-2468 <br /> BILL to inventoried FACILITY: <br /> Location: 678 N WILSON WAY #15 (Must have FACILITY ID#) <br /> ............................._..........................____._....__..._...._._._........................... <br /> Complainant : <br /> <br /> _ a <br /> FACILITY LOCATION/Property Info <br /> DBA or Name: WAL.GF2EEN5.................. <br /> __ _ ...._..................._...._......... ......._ _ ...........Loc Code : 01 <br /> Address- 678....N...IWIL.SON......WAY 15 1. : .:. -,........BOS Dist : <br /> City : ST0CKT0N, 95205 APN # J <br /> Phone . 708-940--2500 <br /> i� <br /> II <br /> BILLING RESPONSIBLE PARTY or OWNER Info — <br /> Name : WA'LGREE,N......CQMPANY.........................__...._................ <br /> ...._.......W._.__......_._......._................Home Phone: <br /> Address: 300 WILwMOT RD _ .Work Phone: 708-317-5418 <br /> city : DEERF_I,EL€P. I_L. 60015 <br /> Nature of Complaint: <br /> BATHROOMS HAVE FECES ON WALLS AND TIOLETS NOT FLUSHING <br /> ;P <br /> a <br /> COMPLAINT Info — <br /> COMPLAINT MODE: P PHONE <br /> j <br /> A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mail/Correseondence <br /> O-Other EH Unit P-Phone <br /> COMPLAINT STATUS: <br /> , 1-Field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued 05-Enforce ACT Initiated <br /> /O6}Transfer to Premise File 07-Refer to Other Agency 08-Not Valid O9-Foodborne illness <br /> Send Referral Letter to: <br /> Address: <br /> Referral Letter Sent by: Date : .' -- <br /> Circle appropriate Unit 4 if complaint in another PROGRAM jurisdiction, Have Complaint Record and P/E updated <br /> Forwarded to UNIT: I 11 III IV for Investigation !� <br />