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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 1608 - CLASS A COTTAGE FOOD-DIRECT SALES <br />Permit ID # PT0023514 for Record ID # PR0538083 <br />Valid From 11/1/2021 To 10/31/2022 <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 />DUKE, KIM D <br />KIM DUKES OLD VINE BAKESHOP <br />Regulated Facility: <br />1991 E PELTIER RD <br />ACAMPO, CA 95220 <br />Facility ID <br />Account ID <br />Issued <br />FA0021998 <br />AR0040108 <br />10/28/2021 <br />KIM DUKES OLD VINE BAKESHOP <br />DUKE, KIM DATTN : Billing Address: <br />KIM DUKES OLD VINE BAKESHOP <br />1991 E PELTIER RD <br />ACAMPO, CA 95220 <br />End of reportcombined.rpt