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COMPLIANCE INFO_2023
EnvironmentalHealth
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PR0160420
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COMPLIANCE INFO_2023
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Last modified
12/28/2023 1:28:28 PM
Creation date
3/17/2023 8:16:12 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0160420
PE
1623
FACILITY_ID
FA0001476
FACILITY_NAME
JIMMIES PLACE SUSHI
STREET_NUMBER
2130
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12309001
CURRENT_STATUS
01
SITE_LOCATION
2130 COUNTRY CLUB BLVD B
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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VPQ 0 I (o 20 <br /> STATE OF CALIFORNIA _ <br /> 4--R4 (a- <br /> CALIFORNIA <br /> DEPARTMENT OF TAX AND FEE ADMINISTRATION GAVINNEWSOM <br /> 2881 Churn Creek Rd.,Ste B Redding CA 96.002 <br /> Governor <br /> 1-530-395-5910•1-530-224-4891(Fax) JEROME.JIMENEZ@CDTFA.CA.GOV NICOLAS MADUROS <br /> www.cdtfa.ca.gov Director <br /> December 8,2023 RECEIVED <br /> County of San Joaquin <br /> Health Department DEC 1 1 2023 <br /> 1868 E Hazelton Ave <br /> Stockton CA 95205 ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> Re: 224-652096 <br /> KUO HSIUNG CHUANG <br /> DBA: JIMMIES PLACE SUSHI <br /> 2130 COUNTRY CLUB BLVD <br /> STOCKTON CA 95204-4800 <br /> To Whom It May Concern: <br /> Government Code section 15570.82 provides the California Department of Tax and Fee Administration <br /> (CDTFA)with the authority to examine books, accounts,and papers of all persons required to report to it,or <br /> having knowledge of the affairs of those required to report.Accordingly,the CDTFA requests that the <br /> following information be furnished: <br /> • Copies of health permits on record and any other documentation pertaining to the permit holder of the <br /> above business. <br /> • A statement from the assigned inspector identifying the owner of the above business at the time of the <br /> most current inspection. <br /> • Information on how any payments or.license fees are paid. If any payments were made by check,please <br /> provide a copy of the check. If a copy is not available please provide the name and address of the bank, <br /> the account and routing number(if available),the name and address of the account holder,and the name <br /> of the person(s)signing the check(s). <br /> Please mail or fax the information to my attention at the address or fax number listed above. No fees should <br /> be billed to the CDTFA for this record request. <br /> If you have any questions or concerns,please contact my office at(530)395-5910. <br /> Thank you in advance for your cooperation. <br /> Sincerely, <br /> Jerome Jim rz <br /> Business Taxes Representative <br /> Redding Office <br /> NAME OF PERSON RESPONDING TO THIS REQUEST(please prinl) TITLE DATE <br /> SIGNATURE TELEPHONE NUMBER <br /> CDTFA-1514 REV.2(2-18) <br />
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