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Location: 3009 $ POCK LN <br />COMPLAINT # = 00013074 <br />n by : 5366 LINEBAUGH Date: I 9 <br />copy Printed: <br />Facility Name: ac ID: <br />Date run: 10/05/99 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVIC Report #5104 , <br />Run by : CAROLD Page # /1 <br />Copy # : 01 of 01 COMPLAINT INVESTIGATION REPORT <br />lv1101W1MtliviNVItIMMMIVIMMMNftlfriMMNIMPIPIMMVOIMMIMMMPIMPItilliWIMMMPIMPIMPIMillviMMPIMPIMPIPIPIMPIPIM/IMPV,IMM <br />Program/Element : ..1-3-210- <br />Assigned to : 5366 LINEBAUGH Date: 10/05199 <br />i <br />BILL to inventoried FACILITY: <br />(Must have FACILITY I0t) <br />Complainant: <br />Address: <br />FACILITY LOCATION/Property Info — <br />DBA or Name: Loc Code,: <br />Address: 3009 S POCK LN BOS Dist : <br /> <br />City: -1-0qKTQN APN # <br />Phone: <br />BILLING RESPONSIBLE PARTY or OWNER Info — <br />Name: Home Phone: <br />Address:Work Phone: <br />City: <br />Nature of Complaint: <br />OPEN, UNSECURED SFD AND BASEMENT. <br />COMPLAINT Info — <br /> <br />COMPLAINT MODE: P PHONE <br />A-Agency Referral B-BD OF Supervisors/City Ccouncil C-Counter M-Mai 1/Correspondence <br />0-Other EH Unit P-Phone <br />COMPLAINT STATUS: 5 <br />01-Field Abated 02-Office Abated 03-NAI Sent 04-Notice to Abate Issued jEnforce ACT Initiated <br />06-Transfer to Premise File 07-Refer to Other Agency 08-Not Valid 09-Foodborne Illness <br />Send Referral Letter to: <br /> <br />Address: <br />Referral Letter Sent by: Date: <br />Circle appropriate Unit # if complaint in another PROGRAM jurisdiction, Have Complaint Record and PIE updated <br />Forwarded to UNIT: III IV for Investigation