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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 />Jasjit Kang, R.E.H.S., Director <br />ENVIRONMENTAL HEALTH <br />PERbHT TO OPERATE - PE 1636 - LTD FOOD VEHICLE I PRODUCE/WHOLE FISH) # S227449 <br />Permit ID # PT0027286 for Record ID # PRO545218 <br />VEHICLE LIC # 39665W1 <br />Valid From 1/1/2022 To 12/31/2022 <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 POSLANA 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 Amount ID AR0043636 <br />LODI, CA 95240 Issued 3/4/2022 <br />Billing Address: ATTN : JIMENEZ SANCHEZ, FERNANDO <br />LA POBLANA RESTAURANTE #39665W1 <br />516 CENTRALAVE <br />LODI, CA 95240 <br />7016 rpt End of Report <br />
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