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EHD Program Facility Records by Street Name
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QUAIL LAKES
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4719
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1600 - Food Program
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PR0547152
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Entry Properties
Last modified
10/28/2021 4:32:36 PM
Creation date
10/28/2021 4:30:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
RECORD_ID
PR0547152
PE
1623
FACILITY_ID
FA0026751
FACILITY_NAME
JUMP START NUTRITION
STREET_NUMBER
4719
STREET_NAME
QUAIL LAKES
STREET_TYPE
DR
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
4719 QUAIL LAKES DR STE H
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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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 - PE 1623 RESTAURANT/BAR 1-20 SEATS <br />Permit ID # PT0028233 for Record ID # PR0547152 <br />Valid From 8/20/2021 To 8/3112022 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause <br />PERMIT(s) Valid only for: LILLARD, BERLIN II <br />DBA: JUMP START NUTRITION <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated Facility: JUMP START NUTRITION Facility lD FA0026751 <br />4719 QUAIL LAKES DR #H AccountlD AR0050987 <br />STOCKTON, CA 95207 Issued 8/31/2021 <br />Billing Address: AT N : LILLARD, BERLIN II <br />JUMP START NUTRITION <br />1515 SIEMERING WAY <br />STOCKTON, CA 95209 <br />7024.rpt <br />End of report <br />
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