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1868 E.Hazelton Ave. •Stockton, CA 95205-6232 •Phone (209)468-3420 <br />Jasjit Kang, R.E.H.S., Director <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE - PE 1632 EXEMPT FOOD <br />Permit ID # PT0008064 for Record ID # PR0163038 <br />Valid From 7/1/2021 To 6/30/2022 <br />PERMIT TO OPERATE - PE 1632 EXEMPT FOOD <br />Permit ID # PT0019810 for Record ID # PR0528470 <br />Valid From 7/1/2021 To 6/30/2022 <br />PERMIT TO OPERATE - PE 1632 EXEMPT FOOD <br />Permit ID # PT0019811 for Record ID # PR0528471 <br />Valid From 7/1/2021 To 6/30/2022 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s) Valid only for: <br />DBA: <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />LODI UNIFIED SCHOOL DISTRICT <br />LODI UNIFIED SCHOOL DISTRICT <br />Regulated Facility: <br />10555 THORNTON RD <br />STOCKTON, CA 95209 <br />Facility ID <br />Account ID <br />Issued <br />FA0001106 <br />AR0001104 <br />6/9/2021 <br />LODI USD-BEAR CREEK HIGH SCHOOL <br />FOOD SERVICE DEPARTMENTATTN : Billing Address: <br />LODI USD-BEAR CREEK HIGH SCHOOL <br />1305 E VINE ST <br />LODI, CA 95240 <br />End of report7024.rpt