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COMPLIANCE INFO_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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KETTLEMAN
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1600 - Food Program
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PR0530205
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
5/10/2022 9:06:42 AM
Creation date
2/24/2022 4:48:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0530205
PE
1624
FACILITY_ID
FA0019811
FACILITY_NAME
HOLIDAY INN EXPRESS
STREET_NUMBER
1341
Direction
E
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04931051
CURRENT_STATUS
01
SITE_LOCATION
1341 E KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Department of Alcoholic Beverage Control State of California Ov <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) <br /> ABC 211(6/99) <br /> TO:Department of Alcoholic Beverage Control File Number: 634020 <br /> 31 E CHANNEL ST Receipt Number: 2699200 <br /> ROOM 168 Geographical Code: 3902 <br /> STOCKTON95202 Copies Mailed Dat�It,—."eC:2p, t <br /> (209)948-773939 Issued Date: t�y <br /> DISTRICT SERVING LOCATION: STOCKTON <br /> First Owner: CY3 LLC DEC 2 2 2021 <br /> Name of Business: HOLIDAY INN EXPRESS <br /> ENVIRONMENTAL HEALTH <br /> Location of Business: 1337 E KETTLEMAN LN PERMIT/SERVICES <br /> LODI,CA 95240 <br /> County: SAN JOAQUIN <br /> Is Premises inside city limits? Yes Census Tract: 0044.04 <br /> Mailing Address:(If different 309 PROSPERITY BLVD <br /> from HOLIDAY INN EXPRESS <br /> premises address) CHOWCHILLA,CA 93610 <br /> Type of license(s): 70 Dropping Partner: Yes_ No_ <br /> Transferor's license/name: 509736 / LCS-MANAGEMENT,INC. <br /> License Type Transaction Type Master Secondary LT And Count <br /> 70-On-Sale General Restrictive Scrvie PER Y <br /> License Type Transaction Description Fee Code Duo Date Fee <br /> Application Fee PERSON TO PERSON TRF NA 0 12/20/21 $1,250.00 <br /> Application Fee ISSUE TEMPORARY PERMIT NA 1 12/20/21 $100.00 <br /> Application Fee STATE FINGERPRINTS NA 5 12/20/21 $195.00 <br /> Application Fee FEDERAL FINGERPRINTS NA 5 12/20/21 $120.00 <br /> 70-On-Sale General Restrictive: ANNUALFEE P40 0 12/20/21 $1,235.00 <br /> Total $2,900.00 <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 County of SAN JOAQUIN Date: December 20,2021 <br /> Applicant Name(s) <br /> CY3 LLC <br />
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