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SITE INFORMATION AND CORRESPONDENCE (2)
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2900 - Site Mitigation Program
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PR0541936
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SITE INFORMATION AND CORRESPONDENCE (2)
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Last modified
5/18/2020 11:15:09 AM
Creation date
5/18/2020 10:55:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0541936
PE
2957
FACILITY_ID
FA0006149
FACILITY_NAME
RANCH MARKET
STREET_NUMBER
23569
Direction
S
STREET_NAME
SANTA FE
STREET_TYPE
RD
City
RIVERBANK
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
23569 S SANTA FE RD
QC Status
Approved
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LSauers
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EHD - Public
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Department of Alcoholic Beverage C9-I . State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) <br /> ABC 211 (6199) <br /> TO: Department of Alcoholic Beverage Control File Number: 433806 2005 NOY 21 PH 12: 22 <br /> Number: 1542947 <br /> 31 East Channel Street . Receipt <br /> GeoSAN JC1AOUilN COUNTY <br /> Room 168 graphical Code: 3900 EN, , <br /> Copies Mailed Date: Novemb#JEd¢TF ARTH <br /> Stockton, CA 95201 ENT <br /> (209) 948-7739 Issued Date: <br /> DISTRICT SERVING LOCATION: STOCKTON <br /> First Owner: OBAID MUNIR WAZE <br /> Name of Business: RANCH MARKET <br /> Location of Business: 23569 S SANTA FE <br /> RIVERBANK, CA 95367 <br /> County: SAN JOAQUIN <br /> Is premise inside city limits? No Census Tract 0049.98 <br /> Mailing Address: 1304 HOLM AVE <br /> (If different from MODESTO, CA 95351 <br /> premises address) <br /> Type of license(s): 21 <br /> Transferor's license/name: 382601 / RANDHAWA KAP Dropping Partner: Yes_ No <br /> License Type Transaction Type Fee Type Master Duu Date Fee <br /> 21 OFF-SALEGENERAL PERSON TO PERSON TRANSF NA Y 0 11/16/05 $1,274.00 <br /> 21 OFF-SALE GENERAL ANNUALFEE NA Y 0 11/16/05 $507.00 <br /> Total $1,781.00 <br /> Have you ever been convicted of a felony? No <br /> Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the <br /> Department pertaining to the Act? No <br /> Explain any "Yes" answer to the above questions on an attachment which shall be deemed part of this application. <br /> Applicant agrees (a) that any manager employed in an on-sale licensed premise will have all the <br /> qualifications of a licensee, and (b) that he will not violate or cause or permit to be violated any of the <br /> provisions of the Alcoholic Beverage Control Act. <br /> STATE OF CALIFORNIA County of SAN JOAQUIN Date: November 16, 2005 <br /> Under penalty of perjury, each person whose signature appears below, certifies and says: (1) He is an applicant, or one of the applicants, or an <br /> executive officer of the applicant corporation, named in the foregoing application, duly authorized to make this application on its behalf; (2) that <br /> he has read the foregoing and knows the contents thereof and that each of the above statements therein made are true; (3) that no person other <br /> than the applicant or applicants has any direct or indirect interest in the applicant or applicant's business to be conducted under the license(s) for <br /> which this application is made; (4) that the transfer application or proposed transfer is not made to satisfy the payment of a loan or to fulfill an <br /> agreement entered into more than ninety (90) days preceding the day on which the transfer application is filed with the Department or to gain or <br /> establish a preference to or for any creditor or transferor or to defraud or injure any creditor of transferor; (5) that the transfer application may <br /> be withdrawn by either the applicant or the licensee with no resulting liability to the Department. <br /> A Applicant Signature(s) <br /> OBAID MUNIR WAZE See, 211 Signature Istage <br /> �i <br />
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