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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# PT0021947 for Record ID# PR0535789 <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: DEPT OF AGING (HSA) <br /> DBA: LODI COMMUNITY SERVICE CENTER <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: LODI COMMUNITY SERVICE CENTER Facility ID FA0020618 <br /> 415 S SACRAMENTO ST Account ID AR0036935 <br /> LODI CA 95240 Issued 6/14/2022 <br /> Billing Address: LODI COMMUNITY SERVICE CENTER <br /> 415 S SACRAMENTO ST <br /> LODI CA 95240 <br /> 7027.rpt End of Report <br />