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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934*
PACIFICHEALTH LABORATORIES, INC.
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(Name of Issuer)
COMMON STOCK, $.0025 PAR VALUE
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(Title of Class of Securities)
695113 10 0
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(CUSIP Number)
June 22, 1999
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(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this
Schedule is filed:
[ ] Rule 13d-1(b)
[X] Rule 13d-1(c)
[ ] Rule 13d-1(d)
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities,
and for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be
deemed to be "filed" for the purpose of Section 18 of the Securities Exchange
Act of 1934 ("Act") or otherwise subject to the liabilities of that section of
the Act but shall be subject to all other provisions of the Act (however, see
the Notes).
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<TABLE>
<S> <C> <C> <C>
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CUSIP No. 695113 10 0 13G PAGE 2 OF 5 PAGES
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1 NAME OF REPORTING PERSON
I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Jemison Investment Co., Inc.
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) [ ]
(b) [X]
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3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware
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NUMBER OF SHARES 5 SOLE VOTING POWER
BENEFICIALLY OWNED
BY EACH REPORTING 320,922
PERSON
WITH
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6 SHARED VOTING POWER
0
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7 SOLE DISPOSITIVE POWER
320,922
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8 SHARED DISPOSITIVE POWER
0
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
320,922
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10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [ ]
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11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.9%
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12 TYPE OF REPORTING PERSON*
CO
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</TABLE>
*SEE INSTRUCTION BEFORE FILLING OUT!
Page 2 of 5
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ITEM 1(A). NAME OF ISSUER: PacificHealth Laboratories, Inc.
ITEM 1(B). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES:
1460 Route 9 North
Woodbridge, NJ 07095
ITEM 2(A). NAME OF PERSON FILING: Jemison Investment Co., Inc.
ITEM 2(B). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE:
2001 Park Place, Suite 320
Birmingham, Alabama 35203
ITEM 2(C). CITIZENSHIP: Delaware
ITEM 2(D). TITLE OF CLASS OF SECURITIES: Common Stock, $.0025 par value
ITEM 2(E). CUSIP NUMBER: 695113 10 0
ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULE 13D-1(B),
OR 13D-2(B) OR (C), CHECK WHETHER THE PERSON FILING IS:
Not applicable
ITEM 4. OWNERSHIP.
(a) Amount Beneficially Owned: 320,922 Shares
(b) Percent of Class: 6.9%
(c) Number of Shares as to Which Such Person Has:
(i) Sole power to vote or to direct the vote: 320,922 Shares
(ii) Shared power to vote or to direct the vote: 0 Shares
(iii) Sole power to dispose or to direct the disposition of:
320,922 Shares
(iv) Shared power to dispose or to direct the disposition of: 0
Shares
ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS.
Not applicable.
ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON.
Not applicable.
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ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH
ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING
COMPANY.
Not applicable.
ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP.
Not applicable.
ITEM 9. NOTICE OF DISSOLUTION OF GROUP.
Not applicable.
ITEM 10. CERTIFICATION.
By signing below the undersigned corporation certifies that, to the best
of its knowledge and belief, the securities referred to above were not acquired
and are not held for the purpose of or with the effect of changing or
influencing the control of the issuer of the securities and were not acquired
and are not held in connection with or as a participant in any transaction
having that purpose or effect.
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SIGNATURES
After reasonable inquiry and to the best of my knowledge and
belief, I certify that the information set forth in this statement is true,
complete and correct.
Date: September 5, 2000 JEMISON INVESTMENT CO., INC.
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By: /s/ James D. Davis
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James D. Davis
Its President
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