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COMPLIANCE INFO_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0524191
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
3/22/2023 3:16:28 PM
Creation date
12/19/2022 9:45:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0524191
PE
1624
FACILITY_ID
FA0016242
FACILITY_NAME
THE GRATEFUL GYPSY BISTRO
STREET_NUMBER
12562
Direction
E
STREET_NAME
LOCKE
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237
APN
05132012
CURRENT_STATUS
01
SITE_LOCATION
12562 E LOCKE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\jcastaneda
Tags
EHD - Public
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Department of Alcoholic Beverage Control State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) <br /> ABC 211 (6/99) <br /> TO:Department of Alcoholic Beverage Control File Number: 642222 <br /> 31 E CHANNEL ST Receipt Number: 2768488 <br /> ROOM 168 Geographical Code: 3900 <br /> STOCKTON, CA 95202 Copies Mailed Date: December 21,2022 <br /> (209)948-7739 Issued Date: <br /> DISTRICT SERVING LOCATION: STOCKTON <br /> First Owner: FREEMAN,LISA M <br /> Name of Business: GRATEFUL GYPSY BISTRO <br /> Location of Business: 12562 LOCKE RD <br /> LOCKEFORD, CA 95237 <br /> County: SAN JOAQUIN <br /> Is Premises inside city limits? No Census Tract: 0047.01 <br /> Mailing Address:(If different <br /> from <br /> premises address) <br /> Type of license(s): 47 Dropping Partner: Yes_ No <br /> Transferor's license/name: <br /> License Type Transaction Tune Master Secondary LT And Count <br /> 47-On-Sale General Eating Place ORI Y <br /> License Tyne Transaction Description Fee Code Dun Date Fee <br /> Application Fee ADD PRIMARY LICENSE TYPE NA 0 10/03/22 $16,560.00 <br /> 47-On-Sale General Eating Placa ANNUAL FEE PO 0 12/21/22 $825.00 <br /> Total $17,385.00 <br /> Have you ever been convicted of a felony? No <br /> Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the <br /> Department pertaining to the Act? No <br /> STATE OF CALIFORNIA County of SAN JOAQUIN Date: October 3,2022 <br /> Applicant Name(s) <br /> FREEMAN,LISA M <br /> FREEMAN,JAMIE L <br />
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