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Environmental Management <br />Department <br />Marie Woodin, Director <br />OUT OF COUNTY COMMISSARY <br />PR 0S3 b--� bg <br />Name of MFF: Lee's CVS--� i . Ao�-c�,-\ <br />Name of Commissary: <br />Commissary Address: 2 `4 "-k O S. VJa� <br />If the proposed facility is located outside of Sacramento County, the local Environmental Health <br />Department shall verify that the commissary and/or commercial kitchen h ent health permit by <br />signing below. The establishment is in sc�� J ck:Aq w, V- Co`untyr ity. <br />An REHS signature verifies that the facility indicated in above meets CALCODE Section 114294-114297. <br />Out of County REHS Name (Please Print) <br />Out of County REHS Signature <br />ZO"\- lel b- X02.5 <br />Phone Number <br />—a- :'u cA3 <br />REHS number <br />2� �� 202Z_ <br />Date <br />Q� S'vtoJ • �� <br />Email Address <br />11080 White Rock Road, Ste. 200 . Rancho Cordova, California 95670 • fax (916) 875-8513 <br />Environmental Compliance (916) 875-8550 . Environmental Health (916) 875-8440 <br />wn•w.saccountv.net • emd.saccountv.net <br />