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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0547792
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Entry Properties
Last modified
4/4/2023 10:23:23 AM
Creation date
8/4/2022 3:19:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
RECORD_ID
PR0547792
PE
1633
FACILITY_ID
FA0027227
FACILITY_NAME
RAW COFFEE CO #82693M2
STREET_NUMBER
1301
Direction
S
STREET_NAME
SACRAMENTO
STREET_TYPE
ST
City
LODI
Zip
95240
APN
04529028
CURRENT_STATUS
01
SITE_LOCATION
1301 S SACRAMENTO ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\bmascaro
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EHD - Public
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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 1633 - FOOD VEHICLE/CART (LTD FOOD PREP) # S227621 <br />Permit ID # PT0028724 for Record ED # PRO547792 <br />VEHICLE LIC # 82693M2 <br />Valid From 6/14/2022 To 12/31/2022 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: WHITE, RICHARD <br />DBA: RAW COFFEE CO <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON TFrE PREMISES <br />Regulated Facility: RAW COFFEE CO #82693M2 <br />Facility ID FA0027227 <br />1301 S SACRAMENTO ST <br />Account ID AR0052255 <br />LODI, CA 95240 <br />Issued 6/16/2022 <br />Billing Address: ATTN : WHITE, RICHARD <br />RAW COFFEE CO #82693M2 <br />2653 MALLARD CT <br />VALLEY SPRINGS, CA 95252 <br />7e16,Mt <br />End o/ Repos <br />
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