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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 1632 -EXEMPT FOOD <br /> Permit ID# PT0029334 for Record ID# PR0548569 <br /> Valid From 7/1/2023 To 6/30/2024 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: LAMMERSVILLE UNIFIED SCHOOL DIST <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: EVELYN COSTA ELEMENTARY SCHOOL Facility ID FA0027769 <br /> 143 MUELA RANCH RD Account ID AR0053885 <br /> MOUNTAIN HOUSE CA 95391 Issued 7/21/2023 <br /> Billing Address: ATTN : HILL, BERNIE <br /> EVELYN COSTA ELEMENTARY SCHOOL <br /> 111 S DE ANZA BLVD <br /> MOUNTAIN HOUSE CA 95391 <br /> 7027.rpt End of Report <br />