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Department of Alcoholic Beverage Control State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) <br /> ABC 211(6/99) <br /> TO:Department ofAlcoholic Beverage Control File Number: 643063 <br /> 31 E CHANNEL ST Receipt Number: 2755460 <br /> ROOM 168 Geographical Code: 3907 <br /> STOCKTON,CA 95202 Copies Mailed Date: O4teberr40,-a63a Dec <br /> (209)948-7739 Issued Date: <br /> DISTRICT SERVING LOCATION: STOCKTON RECEIVED <br /> First Owner: SAVE MART SUPERMARKETS LLC <br /> Name of Business: SAVE MART 94 <br /> DEC 19 2022 <br /> Location of Business: 15240 S HARLANRD <br /> LATHROP,CA 95330-9754 <br /> ENVIRONMENTAL HEALTH <br /> County: SAN JOAQUIN P E R N11 Ti S E RV I C ES <br /> Is Premises inside city limits? Yes Census Tract: 0051.19 <br /> Mailing Addre.ss:(If different PO BOX 4664 <br /> from MODESTO,CA 95352-4664 <br /> premises address) <br /> Type of license(s): 21,86 Dropping Partner: Yes_ No_ <br /> Transferor's license/name: 428680 / SAVE MART SUPERMARKETS <br /> License Type Transaction Npe Master Secondary LT And Count <br /> 21-Ott Sale General PER Y <br /> 86-Instructional Testing License PER Y <br /> License Type Transaction Description Fee Code Dug Date Fee <br /> Application Fee PERSON TO PERSON TRF NA 0 10/10/22 $1,305.00 <br /> Application Fee ISSUE TEMPORARY PERMIT NA 2 10/11/22 $200.00 <br /> 86-Instructional Tasting License ANNUAL FEE NA 0 10/10/22 $405.00 <br /> 21-Off-Sale General ANNUAL FEE NA 0 10/10/22 5849.00 <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 /> SAVE MART SUPERMARKETS LLC <br /> OS Zub35 <br /> � � <br /> 00 1 e 753 \03 <br />