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COMPLIANCE INFO_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0548691
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
1/4/2024 1:00:53 PM
Creation date
11/6/2023 3:16:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548691
PE
1617
FACILITY_ID
FA0027447
FACILITY_NAME
MOUNTAIN HOUSE CHEVRON
STREET_NUMBER
1124
Direction
N
STREET_NAME
INTERNATIONAL
STREET_TYPE
PKWY
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
1124 N INTERNATIONAL PKWY
P_LOCATION
03
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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Department of Alcoholic Beverage Control State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE <br /> ABC 211(6/99) <br /> TO:Department of Alcoholic Beverage Control File Number: 653723 <br /> 3021 REYNOLDS RANCH PKWY Receipt Number: 2843501 <br /> STE 150 Geographical Code: 3906 <br /> LODI,CA 95240 Copies Mailed Date: October 18, <br /> (209)371-6761 Issued Date: iE C E I V E D <br /> DISTRICT SERVING LOCATION: STOCKTON <br /> First Owner: TRACY STATION LLC OCT 2 3 1023 <br /> Name of Business: CHEVRON ENVIRONMENTAL HEALTH <br /> Location of Business: 1124 NORTH INTERNATIONAL PARKWAY DEPARTMENT <br /> TRACY,CA 95376 <br /> County SAN JOAQUIN <br /> Is Premises inside city limits Yes Census Tract: 0052.07 <br /> Mailing Address:(If different 2648 GAYLEY PL <br /> from SAN JOSE,CA 95135 <br /> premises address) <br /> Type of license(s): 20 Dropping Partner: Yes_ No <br /> Transferor's license/name: 629952 / JANT,LLC <br /> License Tvne Transaction Tyne Master Secondary LT And Count <br /> 20-Off-Sale Beer And Wine PER Y <br /> License Tvne Transaction Description Fee Code Duo Date Fee <br /> Application Fee ISSUE TEMPORARY PERMIT NA 1 10/18/23 $100.00 <br /> Application Fee PERSON TO PERSON TRF NA 0 10/18/23 $365.00 <br /> 20-Off-Sale Beer And Wine ANNUAL FEE NA 0 10/18/23 $435.00 <br /> Total $900.00 <br /> Have you ever been convicted of a felony? No <br /> Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the <br /> Department pertaining to the Act? No <br /> STATE OF CALIFORNIA County of SAN JOAQUIN Date: October 18,2023 <br /> Applicant Name(s) <br /> TRACY STATION LLC <br /> P � � S \,A0 <br />
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