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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 1617-RETAIL MARKET> 1000 SQ FT W/FOOD PREP <br /> Permit ID# PT0000245 for Record ID # PR0161892 <br /> Valid From 5/1/2022 To 4/30/2023 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: SINGH, HARI <br /> DBA: COLLIERVILLE COUNTRY STORE <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: COLLIERVILLE COUNTRY STORE Facility ID FA0000238 <br /> 3706 E COLLIER RD Account ID AR0000237 <br /> ACAMPO, CA 95220 Issued 3/25/2022 <br /> Billing Address: ATTN : COLLIERVILLE COUNTRY STORE <br /> HARI SINGH <br /> 10234 MARUYAMA CT <br /> SACRAMENTO, CA 95829 <br /> combined.rpt End of report <br />