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?,IWA <br /> y` SAN:IOAQUIN Environmental Health Department <br /> --- COUNTY — <br /> d, il`S. lireet»®ss grows Me;cR, SALVADORBUENROSTRO <br /> DBA CALIFORNIA7TRUCK WASH <br /> 30 S CALFORNIA ST <br /> COMMISSARY AGREEMENT STOCKTON,CA 95203 <br /> Mobile Food Facility♦ Caterer <br /> Complete sections 1 and 2. If your commissary is located outside of San Joaquin County also complete section 3. <br /> 1. ?. W, p eted by APPLIC ', <br /> Business Name EL PUENTE TAQUERIA Lic. Plate# 7V67266 <br /> Owner/Operator Name JOSE GARCIA & PEDRO GARCIA <br /> Business Mailing Address 1941 E. MARSH ST. <br /> City STOCKTON State CAZip 95205 Bus. Ph. 2092986970 Alt. Ph. <br /> I, hereby state that the above information is current,true and correct to <br /> the best of my knowledge and agree to utilize my approved commissary in accordance with Califomia Health & <br /> Safety Code, and San Joaquin County Environmental Health Department (EHD) requirements. If the use of the <br /> commissary is discontinued, the permit holder must notify the EHD. Failure to notify this office may result in permit <br /> revocation and penalbe <br /> Signature Date 10/26/2022 <br /> 2. Tobe com"`etecL;b , COMMISSARY OWNER/OPERATOR <br /> Commissary Name California Catering Truck Wash FA# 209-464-9707 <br /> Address 730 S California St Bus. Phone 209-271-1741 <br /> City Stockton Zip 95203 Owner/Operator Salvador Buenrostro & Carmen Rivera <br /> Check all appropriate services provided: <br /> g Wastewater disposal M 3-compartment sink 12 Electrical hook-ups <br /> 6 Solid waste disposal GT Food preparation 12 Toilet and handwashing <br /> ® Hot & Cold water for cleaning U Store refrigerated food U Potable water <br /> ® Store dry food/supplies Ca' Overnight parking EF Vehicle wash <br /> I, , hereby state that the information I have provided is current,true and <br /> correct to the best of my knowledge,and meets the California Health&Safety Code requirements. If the food facility <br /> operator fails to comply with the conditions of this agreement, or if this agreement is modified or cancelled, the <br /> commissary w r shall otity the EHD imme ' ly. . <br /> Signature IV Date 10/26/22 <br /> The commissary is located in County. The above food facility meets the <br /> commissary requirements in California Health & Safety Code. The above checked services are available at the <br /> above commissary. Please notify EHD if the status of their operating permit changes. <br /> REHS Signature Date <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br />