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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELEVENTH
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1200
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1600 - Food Program
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PR0161568
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
11/19/2024 10:19:36 AM
Creation date
10/27/2021 2:04:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0161568
PE
1617
FACILITY_ID
FA0003143
FACILITY_NAME
KOVALAM GROCERY & RESTAURANT
STREET_NUMBER
1200
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
1200 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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Customer Authorization Signature: Date: <br /> Company Authorization Signature: Date: <br /> Company License#OPR11081 Page 3 of 3 <br />
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