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COMPLIANCE INFO_2024
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MOUNTAIN HOUSE
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19677
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1600 - Food Program
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PR0548088
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
9/11/2024 9:44:03 AM
Creation date
9/10/2024 2:51:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0548088
PE
1624
FACILITY_ID
FA0027436
FACILITY_NAME
MOUNTAIN MIKE'S PIZZA
STREET_NUMBER
19677
STREET_NAME
MOUNTAIN HOUSE
STREET_TYPE
PKWY
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
01
SITE_LOCATION
19677 MOUNTAIN HOUSE PKWY
P_LOCATION
03
QC Status
Approved
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SJGOV\ymoreno
Tags
EHD - Public
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Department of Alcoholic Beverage Control State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSES) <br /> ABC 211(6/99) <br /> TO:Department of Alcoholic Beverage Control File Number: 639492 <br /> 31 E CHANNEL ST Receipt Number: 2736065 <br /> ROOM 168 Geographical Code: 390y03 <br /> STOCKTON,CA 95202 Copies Mailed Date: ;'i►� ' <br /> (209)948-7739 Issued Date: E <br /> DISTRICT SERVING LOCATION: STOCKTON JUL 18 <br /> 2022 <br /> First Owner: DV PIZZA,INC. <br /> Name of Business: MOUNTAIN MIKES PIZZA ENVIRONMENTAL HEALTH <br /> Location of Business: 19677 MOUNTAIN HOUSE PKWY PERMIT/SERVICES <br /> #170 <br /> MOUNTAIN HOUSE,CA 95391 <br /> County: SAN JOAQUIN <br /> Is Premises inside city limits? Yes Census Tract: 0052.22 <br /> Mailing Address:(If different 1594 WILDPLUM WY <br /> from TRACY,CA 95376 <br /> premises address) <br /> Type of license(s): 41 Dropping Partner: Yes_ No <br /> Transferor's license/name: <br /> License Type Transaction Type Master Secondary LT And Count <br /> 41-On-Sale Beer And Wine-Eating P ORI Y <br /> License Type Transaction Description Fee Code Dup, Date Fee <br /> Application Fee ADD PRIMARY LICENSE TYPE NA 0 07/12/22 $945.00 <br /> 41-On-Sale Beer And Wine-Eat ANNUAL FEE NA 0 07/12/22 $475.00 <br /> Total $1,420.00 <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: July 12,2022 <br /> Applicant Name(s) <br /> DV PIZZA,INC. <br /> ' (� O <s <br />
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