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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 1632 -EXEMPT FOOD <br /> Permit ID# PT0014738 for Record ID# PR0521810 <br /> Valid From 7/1/2022 To 6/30/2023 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: MANTECA UNIFIED SCHOOL DISTRICT <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: MUSD-GEORGE Y KOMURE ELEMENTARY Facility ID FA0014810 <br /> 2121 HENRY LONG BLVD Account ID AR0025236 <br /> STOCKTON CA 95206 Issued 6/14/2022 <br /> Billing Address: ATTN : NUTRITION SERVICES <br /> MUSD-GEORGE Y KOMURE ELEMENTARY <br /> PO BOX 32 <br /> MANTECA CA 95336 <br /> 7027.rpt End of Report <br />