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COMPLIANCE INFO_2015-2018
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1600 - Food Program
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PR0523418
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COMPLIANCE INFO_2015-2018
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Last modified
8/27/2020 3:24:51 PM
Creation date
8/27/2020 3:19:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2018
RECORD_ID
PR0523418
PE
1635
FACILITY_ID
FA0019537
FACILITY_NAME
GARCIA'S CATERING #6F92180
STREET_NUMBER
2440
Direction
S
STREET_NAME
AIRPORT
STREET_TYPE
WAY
City
STOCKTON
Zip
95206
APN
16913327
CURRENT_STATUS
02
SITE_LOCATION
2440 S AIRPORT WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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JCastaneda
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EHD - Public
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VERIFICATION OF VEHICLE COMMISSARY <br /> Please provide all information requested. An incomplete application may delay approval. <br /> VEHICLE INFORMATION <br /> Vehicle Name (DBA): <br /> Address for Vehicle: ,ice c <br /> StreetAddress city <br /> 1) License Plate#: I /5317 4) Year: /V 8c� <br /> 2) Vehicle Vin#: :t6jdH93 Ko:JSSt0 ? /5) Make/Model: tZ male _ <br /> 3) State Decal#: 04 6) Color: whoa <br /> VEHICLE OWNER INFORMATION <br /> Name: Lewd 60601 <br /> Address of Owner: 3a V' <br /> Street Address city <br /> The mobile food facility shall operate out of a commissary and shall report to the commissary at least once each <br /> operating day for cleaning and servicing (CalCode sections 114296 & 114297). If the use of the commissary is <br /> discontinued, the permit holder must notify this office to make the necessary changes. Failure to notify this <br /> office ay result in ermit revocation and penalties. <br /> S' nature of Vehicle Operator Date <br /> COMMISSARY INFORMATION <br /> Business Name: <br /> Owner Name: y <br /> Site Address: <br /> Street Address city <br /> Phone: (Z01 ) 27-7-1— y <br /> I,the commissary owner, can and will provide the necessary facilities for the above mentioned vehicle at my <br /> commissary as checked below: <br /> L [ tensil washing sink quid&solid waste disposal or 3 compartments) Store frozen food Vehicle wash facilities <br /> reparation of food Wmot&cold water for cleaning EI Toilet&hand washing B//tore refrigerated food <br /> Store dry food/supplies sProvide potable water [5/overnight parking W Adequate electrical outlets <br /> S'g ure of Comm iss wner/O perator Dat <br /> HEALTH DEPARTMENT <br /> If the commissary/food establishment is outside San Joaquin County, the local health jurisdiction must verify <br /> current health permit by signing below. Commissary/food establishment is in <br /> County. <br /> Signature of County REHS Date <br /> EHD 16-017 5 o1`6 MFPU APPLICATION <br /> 7/1812008 <br />
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