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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0548393
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Entry Properties
Last modified
4/24/2024 3:01:57 PM
Creation date
6/22/2023 2:26:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
RECORD_ID
PR0548393
PE
1635
FACILITY_ID
FA0027637
FACILITY_NAME
IGNIS PROVISIONS #4VD5058
STREET_NUMBER
620
Direction
S
STREET_NAME
SACRAMENTO
STREET_TYPE
ST
City
LODI
Zip
95240
APN
04532005
CURRENT_STATUS
01
SITE_LOCATION
620 S SACRAMENTO ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\ymoreno
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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 1635 - MOBILE FOOD PREPARATION UNIT(MFPU) <br /> Permit ID# PT0029198 for Record ID# PR0548393 <br /> VEHICLE LIC #4VD5058 <br /> Valid From 1/1/2024 To 12/31/2024 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s) Valid only for: CORTEZ, DANIEL <br /> DBA: IGNIS PROVISIONS <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility IGNIS PROVISIONS#4VD5058 Facility ID FA0027637 <br /> 620 S SACRAMENTO ST Account ID AR0053585 <br /> LODI, CA 95240 Issued 4/11/2024 <br /> Billing Address: ATTN : CORTEZ, DANIEL <br /> IGNIS PROVISIONS#4VD5058 <br /> 1031 S HAM LN <br /> LODI, CA 95242 <br /> combmedrpt <br /> End of report <br />
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