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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E.Hazelton Ave•Stockton,CA 95205-6232•Phone(209)468-3420 <br /> Jasjit Kang,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 1695-TEMPORARY EVENT <br /> Permit ID#PT0028297 for Record ID# PR0547234 <br /> Valid From 10/3/2021 To 10/3/2021 <br /> Valid From 10/10/21 To 10/10/21 <br /> Valid From 10/24/21 To 10/24/21 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: BENSON, MICHAEL <br /> DBA: CENTRAL VALLEY LIONS YOUTH FOOTBALL& CHEE <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: CENTRAL VALLEY LIONS YOUTH FOOTBAL Facility to FA0026811 <br /> .221 E LAWRENCE AVE Account'O AR0051128 <br /> LODI CA 95240 issued 9/30/2021 <br /> Billing Address: ATTN : BENSON, MICHAEL <br /> CENTRAL VALLEY LIONS YOUTH FOOTBALL& CHEER <br /> 1857 LONGDON DR <br /> STOCKTON CA 95206 <br /> 7o2o.rpt _ <br />