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COMPLIANCE INFO_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0507849
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
3/17/2023 1:51:16 PM
Creation date
3/17/2022 1:38:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0507849
PE
1619
FACILITY_ID
FA0007582
FACILITY_NAME
Save Mart #781
STREET_NUMBER
875
Direction
S
STREET_NAME
TRACY
STREET_TYPE
Blvd
City
Tracy
Zip
95376
APN
242-020-220-000
CURRENT_STATUS
01
SITE_LOCATION
875 S Tracy Blvd
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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Department of Alcoholic Beverage Control State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) <br /> ABC 211(6199) <br /> TO:Department of Alcoholic Beverage Control File Number: 642928 <br /> 31 E CHANNEL ST Receipt Number: 2755111 <br /> ROOM 168 Geographical Code: 3906 <br /> STOCKTON,CA 95202 Copies Mailed Date: 9eMber40e-2022%kJN .jq1 292,"_ <br /> (209)948-7739 Issued Date: <br /> DISTRICT SERVING LOCATION: STOCKTON <br /> First Owner: LUCKY STORES(SAVE MART)LLC <br /> Name of Business: SAVE MART SUPERMARKETS 781 <br /> Location of Business: 875 S TRACY BLVD <br /> TRACY,CA 95376-4744 <br /> County: SAN JOAQUIN <br /> Is Premises inside city limits? Yes Census Tract: 0054.03 <br /> Mailing Address:(If different PO BOX 4664 <br /> from MODESTO,CA 95352-4664 <br /> premises address) <br /> Type of license(s): 21,86 <br /> Dropping Partner: Yes_ No <br /> Transferor's license/name: 449749 / LUCKY STORES INC <br /> License Tyre Transaction Type Master Secondary LT And Count <br /> 21-Off-Sale Genera) PER Y <br /> 86-Instn,etienel Tasting License PER Y <br /> License TVDe Transaction Descrirtion Fee Code Dur Date Fee <br /> Application Fee ISSUE TEMPORARY PERMIT NA 1 10/10/22 5100.00 <br /> Application Fee PERSON TO PERSON TRF NA 0 10/1022 $1,305.00 <br /> Application Fee ISSUE TEMPORARY PERMIT NA 1 10/10/22 SI00.00 <br /> 86-Irut[uctional Tasting License ANNUALFEE NA 0 10/1022 $405.00 <br /> 21-Off-Sale General ANNUALFEE NA 0 10/1022 $849.00 <br /> Total 52,759.00 <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 10,2022 <br /> Applicant Name(s) <br /> LUCKY STORES(SAVE MART)LLC <br /> 050-+ S '-� <br /> C) o-0 � 2 <br /> s <br />
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