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BILLING_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0539463
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BILLING_2021
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Entry Properties
Last modified
8/23/2021 2:36:43 PM
Creation date
8/23/2021 2:24:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
FileName_PostFix
2021
RECORD_ID
PR0539463
PE
1624
FACILITY_ID
FA0022562
FACILITY_NAME
DOMINOS
STREET_NUMBER
107
Direction
W
STREET_NAME
NORTH
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21723311
CURRENT_STATUS
01
SITE_LOCATION
107 W NORTH ST STE 10
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
Accounting
Supplemental fields
EmailAddr
AR0041254 ;
FilePath
D:\CAPTURE\EHD\Batch\Operating Permits
ParentPath
Operating Permits
PermitRecordID
PR0539463
Tags
EHD - Public
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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 1624 - RESTAURANT/BAR 21-50 SEATS <br />Permit ID # PT0024247 for Record ID # PR0539463 <br />Valid From 9/1/2021 To 8/31/2022 <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 />TEAM CENTRAL VALLEY INC <br />DOMINOS <br />Regulated Facility: <br />107 W NORTH ST #10 <br />MANTECA, CA 95336 <br />Facility ID <br />Account ID <br />Issued <br />FA0022562 <br />AR0041254 <br />8/23/2021 <br />DOMINOS <br />DEGRANDIS, GREGATTN : Billing Address: <br />DOMINOS <br />2930 GREER RD STE 174 <br />TURLOCK, CA 95382 <br />End of reportcombined.rpt
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