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BILLING_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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KETTLEMAN
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2347
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1600 - Food Program
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PR0505996
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BILLING_2023
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Entry Properties
Last modified
8/25/2023 2:41:37 PM
Creation date
8/25/2023 2:39:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
FileName_PostFix
2023
RECORD_ID
PR0505996
PE
1626
FACILITY_ID
FA0007134
FACILITY_NAME
BLACK BEAR DINER - LODI
STREET_NUMBER
2347
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
CURRENT_STATUS
01
SITE_LOCATION
2347 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved - Send Email
Scanner
Accounting
Supplemental fields
EmailAddr
AR0010334 burtbenepal@aol.com;CRC@blackbeardiner.com
EmailSent
8/25/2023 2:41:34 PM
FilePath
D:\CAPTURE\EHD\Batch\Operating Permits
ParentPath
Operating Permits
PermitRecordID
PR0505996
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 1626 RESTAURANT/BAR 101 + SEATS <br /> Permit ID# PT0008484 for Record ID# PR0505996 <br /> Valid From 10/1/2023 To 9/30/2024 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: CALIFORNIA RESTAURANT CONCEPTS INC <br /> DBA: BLACK BEAR DINER- LODI <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: BLACK BEAR DINER- LODI Facility ID FA0007134 <br /> 2347 W KETTLEMAN LN Account ID AR0010334 <br /> LODI, CA 95242 Issued 8/25/2023 <br /> Billing Address: ATTN : BENEPAL, BURT <br /> BLACK BEAR DINER- LODI <br /> 2415 SAN RAMON VALLEY BLVD STE 4403 <br /> SAN RAMON, CA 94583 <br /> 7024.rpt End of report <br />
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