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Department of Alcoholic Beverage Control State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) <br /> ABC 211(6/99) <br /> TO:Department of Alcoholic Beverage Control File Number: 619272 <br /> 31 E CHANNEL ST Receipt Number: 2649156 <br /> ROOM 168 Geographical Code: 3900 <br /> STOCKTON,CA 95202 Copies Mailed Date: September 8,2020 <br /> (209)948-7739 Issued Date: <br /> DISTRICT SERVING LOCATION: STOCKTON <br /> First Owner: ELHADY,IMAN TAHER \'-C, <br /> Name of Business: SAMS MARKET <br /> Location of Business: 11700 FINCK RD <br /> TRACY,CA 95304-8430 <br /> County: SAN JOAQUIN <br /> Is Premises inside city limits? No Census Tract: 0039.00 <br /> Mailing Address:(If different 843 SUMMER LN <br /> from TRACY,CA 95377 <br /> premises address) <br /> Type of license(s): 21 Dropping Partner: Yes_ No_ <br /> Transferor's license/name: 478745 / ELHADY,ARIEF ABDO <br /> License Tyne Transaction Type Master Secondary LT And Count <br /> 21-Off-Sale General FID Y <br /> License Type Transaction Description Fee Code Dun Date Fee <br /> Application Fee FIDUCIARY TRANSFER NA 0 09/08/20 $100.00 <br /> Application Fee ISSUE TEMPORARY PERMIT NA 1 09/08/20 $100.00 <br /> Total $200.00 <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 /> STATE OF CALIFORNIA County of SAN JOAQUIN Date: September 8,2020 <br /> Applicant Name(s) <br /> ELHADY,IMAN TAHER <br /> fpr 3� 3 3 <br /> PCS Bei 2�Li <br /> CEIVE C :2 . ;2 �o <br /> SEP 10 2020 2oi 325--7S <br /> ENVIRONMENTAL HEALT <br /> PERMIT/SERVICES <br /> S <br />