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Environmental Management <br />Department <br />Marie Woodin, Director <br />OUT OF COUNTY COMMISSARY <br />Name of MFF: ~\ o Cis P � S Q C lO <br />Name of Commissary: U ()ICY` y) � SSCP r {--} ZT�,eCCA <br />Commissary Address: C aC) 7�) '50,oL rnec-% S-�, 1-40 CJI 04 C13j( <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 latchen has a current health permit by <br />signing below. The establishment is in County/City. <br />An REHS signature verifies that the facility indicated in above meets CALCODE Section 114294-114297. <br />Out <br />Out of County REHS Name (Please Print) <br />Out of County REHS Signature <br />Phone Number <br />REHS number <br />Date <br />SSFP/,�F c� SJ oV a <br />Email Address <br />10590 Armstrong Avenue •. Mather, California 95655 • fax (916) 6758513 <br />Environmental Compliance (916) 6758550 9 Environmental Health (916) 8758440 <br />