Circle K CallsforService

GLENDALE POLICE DEPARTMENT
Liquor Application Worksheet

Date: 02-26-21
License Type: Series 10 Beer and Wine Store (Beer and Wine only)
Definition: Allows a retail store to sell beer and wine (no other spirituous liquors), only in the original unbroken
package, to be taken away from the premises of the retailer and consumed off the premises.
Application Type: New License

Definition: New license

Business Name: Circle K Store #2709542
Business Address: 10725 W. Northern Ave.

Applicant/s Information
Name: Kwiatkowski, Kim Kenneth (Agent)
Name: Tourek, Timothy Shawn
Name: Cunnington, Kathleen K.
Name: Meza, Janet Kay (Manager)

Background investigation of applicant/s completed.

Calls for Service History: Call history for location New ownership call history
i beginning: 2/26/2016 Other Suites beginning:

Liquor Related

Vice Related

Drug Related

Fights / Assaults

Robberies

Burglary / Theft

911 calls

Trespassing

Accidents

Fraud / Forgery

Threats

Criminal damage

Other non-criminal*

Total calls for service N/A - New Construction NIA NIA

* Other non-criminal includes calls such as suspicious persons, juveniles disturbing and other information only reports that required Police
tesponse or phone call

GLENDALE POLICE DEPARTMENT
Liquor Application Worksheet
Page 2 of 2

Applicant Background Synopsis:

None of the listed applicant(s) have any known felony convictions within the past five years or any other
known criminal history that would lead to police department recommendation for denial.

Current License Holder:

N/A

Location History:

N/A - New construction on empty plot of land.

Special Concerns:

None found.

Background investigation complete:

Police Department recommendation has No Cause for Denial.

Date

Investigating Officer —- M. Ervin /1, Ele A B-4-Z% |

CID Lieutenant or Commander p. 6 LAwto 3/ pf

Deputy City Attorney

Chief of Police or designee Lh Ayo 3fk on)