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Department of Alcoholic Beverage---.ltrol -State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) <br /> ABC 211(6/99) <br /> TO:Department of Alcoholic Beverage Control File Number: 460903 <br /> 31 E CHANNEL ST Receipt Number: 2150122 <br /> ROOM 168 Geographical Code: 3905 RECEiiIED <br /> STOCKTON, CA 95202 Copies Mailed Date: January9,2013 <br /> (209)948-7739 Issued Date: <br /> JAN 10 201, <br /> DISTRICT SERVING LOCATION: STOCKTON <br /> First Owner: FIRST EVERGREEN OIL CORPORATION ' NVIRONMENT,q,L HE4,L.TI l <br /> Name of Business: PARKWOOD GAS& FOOD PERMIT/SERVIOES <br /> Location of Business: 1612 W HAMMER LN <br /> STOCKTON,CA 95209-2922 <br /> County: SAN JOAQUIN <br /> Is Premise inside city limits? Yes Census Tract 0032.03 <br /> Mailing Address: 5500 QUASHNICK RD <br /> (If different from STOCKTON,CA 95212 <br /> premises address) <br /> Type of license(s): 20 <br /> Transferor's license/name: Dropping Partner: Yes No_� <br /> License Type Transaction Type Fee Type Master pup Date Fee <br /> 20-Off-Sale Beer And Wine STOCK TRANSFER NA Y 0 01/09/13 $100.00 <br /> Total $100.00 <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 /> Explain any"Yes"answer to the above questions on an attachment which shall be deemed part of this application. <br /> Applicant agrees(a)that any manager employed in an on-sale licensed premises will have all the qualifications of <br /> a licensee,and(b)that he will not violate or cause or permit to be violated any of the provisions of the Alcoholic <br /> Beverage Control Act. <br /> STATE OF CALIFORNIA County of SAN JOAQUIN Date: January 9,2013 <br /> Under penalty of pedury,each person whose signature appears below,certifies and says:(1) He is an applicant,or one of the applicants,or an executive officer <br /> of the applicant corporation,named in the foregoing application,duly authorized to make this application on its behalf;(2) that he has read the foregoing and <br /> knows the contents thereof and that each of the above statements therein made are true;(3) that no person other than the applicant or applicants has any direct <br /> or indirect interest in the applicant or applicant's business to be conducted under the license(s)for which this application is made;(4) that the transfer <br /> application or proposed transfer is not made to satisfy the payment of a loan or to fulfill an agreement entered into more than ninety(90)days preceding the day <br /> on which the transfer application is filed with the Department or to gain or establish a preference to or for any creditor or transferor or to defraud or injure any <br /> creditor of transferor;(5) that the transfer application may be withdrawn by either the applicant or the licensee with no resulting liability to the Department. <br /> Effective July 1,2012,Revenue and Taxation Code Section 7057,authorizes the State Board of Equalization and the Franchise Tax Board to share <br /> taxpayer information with Department of Alcoholic Beverage Control.The Department may suspend,revoke,and refuse to issLe a license if the <br /> licensee's name appears in the 500 largest tax delinquencies list.(Business and Professions Code Section 494.5.) <br /> Applicant Name(s) Applicant Signature(s) <br /> See 211 Signature Page <br /> FIRST EVERGREEN OIL CORPORATION <br />