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Department of Alcoholic Beverage Control <br />APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) <br />ABC 211(6/99) <br />State of California <br />TO: Department of Alcoholic Beverage Control <br />2400 DEL PASO ROAD <br />SUITE 155 <br />SACRAMENTO, CA 95834 <br />(916) 419-1319 <br />File Number: 635403 <br />Receipt Number: 2705774 <br />Geographical Code: 3900 <br />Copies Mailed Date: February 15, 2022 <br />Issued Date: <br />DISTRICT SERVING LOCATION: <br />First Owner: <br />Name of Business: <br />Location of Business: <br />County: <br />Is Premises inside city limits? <br />Mailing Address:(If different <br />from <br />premises address) <br />Type of license(s): <br />Transferor's license/name: <br />SACRAMENTO <br />SAFE WAY INC <br />SAFE WAY FUEL CENTER #0055FC <br />19533 S MOUNTAIN HOUSE PKWY <br />MOUNTAIN HOUSE, CA 95391 <br />SAN JOAQUIN <br />Yes Census Tract: 0052.23 <br />PO BOX 29096 <br />MAIL STOP #6515 <br />PHOENIX, AZ 95038 <br />20 <br /> Dropping Partner: Yes No <br />589781 / KUMAR, SURESH <br />License Type <br />20 - Off-Sale Beer And Wine <br />Transaction Type <br />PER/PRM <br />Master Secondary LT And Count <br /> <br />License Type <br />Application Fee <br />20 - Off-Sale Beer And Wine <br />Transaction Description Fee Code Dup Date Fee <br />DBL TRF: PREMISES AND PERSON NA 0 02/15/22 $905.00 <br />ANNUAL FEE NA 0 02/15/22 $400.00 <br /> <br />Total $1,305.00 <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 <br />Applicant Name(s) <br />SAFEWAY INC <br />County of SAN JOAQUIN Date: February 15, 2022 <br />P9-0s-419so