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COMPLIANCE INFO_COMPLIANCE INFO 2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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18783
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1600 - Food Program
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PR0161731
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COMPLIANCE INFO_COMPLIANCE INFO 2020
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Entry Properties
Last modified
11/20/2024 9:21:39 AM
Creation date
7/8/2020 8:19:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
COMPLIANCE INFO 2020
RECORD_ID
PR0161731
PE
1623
FACILITY_ID
FA0000261
FACILITY_NAME
OLD CORNER SALOON
STREET_NUMBER
18783
Direction
E
STREET_NAME
STATE ROUTE 88
City
CLEMENTS
Zip
95227
APN
01924019
CURRENT_STATUS
01
SITE_LOCATION
18783 E HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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Department of Alcoholic Beverage Control State of California <br /> SUPPLEMENTAL DIAGRAM Gavin Newsom,Governor <br /> Instructions to Applicant: <br /> Draw a sketch of the area on which the licensed premises is or will be located Show adjacent structures and nearest cross <br /> streets. If this is an event,for a daily license, cateritfg authorization, event authorization or miscellaneous use, show the <br /> area where sales and consumption gfalcoholic beverages will occur. Post a copy of this diagram with Daily License, <br /> Catering Authorization or Event Authorization where the event is held. Sales and consumption of alcoholic beverages <br /> must be confined to the area designated in the diagram and supervised to prevent violations of the.Alcoholic Beverage <br /> Control Act. <br /> 1 APPLICANT NAME (Last,first,middle) 2. LICENSE TYPE <br /> Todd Marvin Anderson on-premise 48-428019 <br /> - – - — —---- - - – -- --- <br /> 3. PREMISES ADDRESS (Street numDerand name,ory,vp code) 4. NEAREST CROSS STREET <br /> 18783 E. Hwy 88 Clements, CA 95220 Mackville Rd. <br /> DIAGRAM <br /> CIO, <br /> G�Tr f <br /> GA RAX-r <br /> 70 <br /> �o�S E BA R <br /> 'Ft <br /> Po,0- ►v <br /> 1 have read the above instructions and I dec are under penalty of perjury that the above diagram is true and correct. <br /> APPLICANT SIGNATURE DATE SIGNED <br /> 05/25/2020 <br /> _ FOR ABC USE ONLY <br /> CERTIFIED CORRECT (SlgnaWre) PRINTED NAME INSPECTION DATE <br /> ABC-253(rev. 07/19) <br />
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