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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0518079
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
2/2/2022 4:16:30 PM
Creation date
10/27/2021 2:32:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0518079
PE
1624
FACILITY_ID
FA0013681
FACILITY_NAME
WATER HOLE TAVERN
STREET_NUMBER
246
Direction
N
STREET_NAME
CLUFF
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
04905039
CURRENT_STATUS
01
SITE_LOCATION
246 N CLUFF AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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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: 626851 <br />31 E CHANNEL ST <br />Receipt Number: 2670470 <br />ROOM 168 <br />Geographical Code: 3902 <br />STOCKTON, CA 95202 <br />(209) 948-7739 <br />Copies Mailed Date: Ma <br />Issued Date: <br />Date <br />dRMED <br />DISTRICT SERVING LOCATION: <br />STOCKTON <br />First Owner: <br />RECO", KATRINA RENEE Kly 2 8 2021 <br />Name of Business: <br />WATER HOLE TAVERN <br />Application Fee <br />ENVIRONMENTALEA_TH <br />Location of Business: <br />246NCLUFFAVE <br />PERMITISERVICES <br />05/26/21 <br />LODI, CA 95240-3146 <br />County: <br />Is Premises inside city limits? <br />Mailing Address:(If different <br />from <br />premises address) <br />Type of license(s): <br />Transferor's license/name: <br />SAN JOAQUIN <br />Yes Census Tract: <br />PO BOX 1208 <br />LOCKEFORD, CA 95237 <br />42 <br />0045.01 <br />Dropping Partner: Yes_ No <br />License Type Transaction Tyne <br />42 - On -Sale Beer And Wine - Public P ORI <br />Master <br />Y <br />Secondary IT And Count <br />License Type <br />Transaction Description <br />Fee Code <br />Dup <br />Date <br />Fee <br />Application Fee <br />STATE FINGERPRINTS <br />NA <br />l <br />05/26/21 <br />$39.00 <br />Application Fee <br />ADD PRIMARY LICENSE TYPE <br />NA <br />0 <br />05/26/21 <br />$905.00 <br />Application Fee <br />FEDERALFINGERPRINTS <br />NA <br />1 <br />05/26/21 <br />$24.00 <br />42 - On -Sale Beer And Wine - Put <br />ANNUAL FEE <br />NA <br />0 <br />05/26/21 <br />$565.00 <br />Total <br />$1,533.00 <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 <br />Applicant Name(s) <br />KATRINA RENEE <br />County of SAN JOAQUIN <br />Q,A&- T <br />Date: May 26, 2021 <br />
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