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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0545218
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Entry Properties
Last modified
4/28/2022 12:48:28 PM
Creation date
5/15/2020 10:37:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
RECORD_ID
PR0545218
PE
1636
FACILITY_ID
FA0025708
FACILITY_NAME
LA POBLANA RESTAURANTE #39665W1
STREET_NUMBER
600
Direction
S
STREET_NAME
CENTRAL
STREET_TYPE
AVE
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
600 S CENTRAL AVE
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E.Hazelton Ave. • Stockton, CA 95205-6232 • Phone(209)468-3420 <br /> Linda Turkatte,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 1636-LTD FOOD VEHICLE (PRODUCE/WHOLE FISH)#S205395 <br /> Permit ID # PT0027286 for Record ID # PRO545218 <br /> VEHICLE LIC #39665W1 <br /> Valid From 1/17/2020 To 12/31/2020 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: JIMENEZ SANCHEZ, FERNANDO <br /> DBA: LA POBLANA RESTAURANTE Y PANDERIA <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: LA POBLANA RESTAURANTE#39665W1 Facility ID FA0025708 <br /> 600 S CENTRAL AVE /account ID AR0048636 <br /> LODI, CA 95240 Issued 1/21/2020 <br /> Billing Address: ATTN : JIMENEZ SANCHEZ, FERNANDO <br /> LA POBLANA RESTAURANTE#39665W1 <br /> 516 CENTRAL AVE <br /> LODI, CA 95240 <br /> 7ot6.rpt <br />
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