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VERFMATOON OF VIEMOCLE COMPA086ARY <br /> r2c <br /> Please proidde all informaeon requested. An WCOMPIeLs,applica0an may delay app �04'L , " 2016 <br /> Vehicle Name(DBA): G�� _ .�: - _ cFS <br /> Address for Vehicles <br /> Address � <br /> 4) Year. <br /> 2) Vehicle Vint#7 <br /> Color., <br /> Y77* <br /> Mame: <br /> Address of b/mer: <br /> "l=cob"a' <br /> fmc"W shall 009faL-Out Of a=mlilftsmY and shall repoit to&a eommftaaW at least ciftee.each <br /> m- <br /> 21a <br /> QW,-Ing day fer(;Iamining dnd,5@rdqInS figdgod4 sections 114299 9 11420?). if&a <br /> Sep,-.If is <br /> 0immInuml,the PDraft holder must m2ify NO QW100 to make the necesem ohaftgu8e a the c;ama'd <br /> es. Failure to nobifit his <br /> Office m6 FeSUR in permit revocadon and pmmWes. <br /> I)e,I <br /> nEn',^R' re 0! Vehicle Opemtor Dab <br /> Business <br /> Name: iQ—�, CItIA <br /> -,& <br /> Owner Niginig- <br /> _Ile <br /> I Site Address: 7-q <br /> a <br /> CW <br /> Phone. (zcqj ) 11:1 i-t <br /> v veblicie at vky <br /> mlissary oiufier,car and will provide the necessaW fad,- 0 the abo e <br /> Mmrllissanj as checked beliom <br /> Liquid&solid juam disposal YJ Utensil washing sink <br /> C%eQStarefrozenfood Vehicle wash facilities <br /> ❑Pre,08ration Of food (@ Hot&cold water for clearing MT010t&hand washingIQ Store Mftarated6adSia �r mad/supplies 4' <br /> Provide notable wafer <br /> Overnight parking if Adequate elechicpJ ciwdets <br /> 8 La n a lure of <br /> Gomm OMWORemior DaL- <br /> H <br /> OMPAR-M <br /> if t1he carnmj,%5Qryjf0g6 Qatabftilmarit is OUWde San joaqWn Coram 910 <br /> y 2h ad health jurfadlegon must veffly <br /> W-,MrWrt heaft pernfit kv spi*tnIS�910W- COM 531ssaFYR006 eSWI0RSI3M9WJ is L-1 <br /> Goun <br /> Signature of Count,REHS Date <br /> iD 96-0t7 <br /> 5 UM <br /> AMOS MITUAPPLICATION <br />