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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 /> ANNUAL OPERATING FEE PAID-PE 4634-TRANSIENT NONCOMMUNITY PUBLIC WATER SYSTEM <br /> Permit ID# PT0026553 for Record ID# PR0543350 <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: LUKOSE,J/MATTHEW,P/PHILIP,J <br /> DBA: COLLEGEVILLE MARKET& CAFE <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: COLLEGEVILLE MARKET &CAFE Facility ID FA0001457 <br /> 13521 E MARIPOSA RD Account ID AR0001456 <br /> STOCKTON CA 95215 Issued 7/5/2022 <br /> Billing Address: COLLEGEVILLE MARKET& CAFE <br /> 13521 E MARIPOSA RD <br /> STOCKTON CA 95215 <br /> 7027.rpt End of Report <br />