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1600 - Food Program
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PR0548301
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Entry Properties
Last modified
5/5/2023 1:34:43 PM
Creation date
3/15/2023 12:39:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
RECORD_ID
PR0548301
PE
1608
FACILITY_ID
FA0027570
FACILITY_NAME
LA LUNA COFFEE CO
STREET_NUMBER
1423
STREET_NAME
TRAILWOOD
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
1423 TRAILWOOD AVE
P_LOCATION
07
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
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 1608 CLASS A COTTAGE FOOD-DIRECT SALES <br />Permit ID # PT0029125 for Record ID # PR0548301 <br />Valid From 3/7/2023 To 3/31/2024 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: RICO, TARA E <br />DBA: LA LUNA COFFEE CO <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated Facility: LA LUNA COFFEE CO <br /> Facility ID FA0027570 <br />1423 TRAILWOOD AVE <br /> Account ID AR0053260 <br />MANTECA, CA 95336 <br /> Issued 3/7/2023 <br />Billing Address: <br />7024.rpt <br />ATTN : RICO, TARA E <br />LA LUNA COFFEE CO <br />1423 TRAILWOOD AVE <br />MANTECA, CA 95336 <br />End of report
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