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. SAN JOAQUIN <br />COUNTY— Environmental Health Department <br />+:. Greatness grows here. <br />SALVADOR BUENRQSTRO <br />DBA CAuFURNIA CATERIN;= TRUCK WASH <br />730 S 1A ST <br />COMMISSARY AGREEMENT STOCK110N,ORNCA95203 <br />Mobile Food Facility v Caterer <br />Complete sections 1 and 2. If your commissary is located outside of San Joaquin County also complete section 3. <br />Business Name PAPAS CITY Lic. Plate # <br />Owner/Operator Name FRANCISCO NOVOA <br />Business Mailing Address 2318 OXFOR <br />City Stockton State CA Zip 95204_ Bus. Ph. 2092308866 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 California Health & <br />Safety Code, and San Joaquin County Environmental Health Department (EHD) requirements. If the use of the <br />commissary is di th permit holder must notify the EHD. Failure to notify this office may result in permit <br />revocation an enalties. <br />2. To <br />Commissary <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 />12 Wastewater disposal U 3 -compartment sink 17 Electrical hook-ups <br />H Solid waste disposal 12 Food preparation (2 Toilet and handwashing <br />® Hot & Cold water for cleaning EF Store refrigerated food Q Potable water <br />H Store dry food/supplies Q Overnight parking 13 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 gwner shall notify the EHD imrrAediately. <br />To be <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 />1:7.R <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjgov.org/ehd <br />