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SAN JOAQUIN Environmentalt Health Department <br /> COMMISSARY AGREEMENT <br /> Mobile Food Facility * Caterer <br /> ff yhiiocattY oat-*hl WS;w.1n7'-pvc Cooritv qJ"qf) S.r.-tjor,:3 <br /> 11-fo-6e'completed' '­ ' ­ b'y'AP'-P*L*-'I-C-A-N-T--------"-' <br /> ............ ------------ <br /> J <br /> Ownpt.op?rntclr Wirt c,, <br /> buzmw.,s"la4inrZI Addwss 'gol J\j (")q 'r <br /> "'tale z1v(�--j Bil <br /> -) 0 5 Eq <br /> L)-4f Alt.. mi..c 5 <br /> .111, Ippnive(I zr, & <br /> oz).t F-1-ir) F <br /> Jk W <br /> 4 <br /> To be completed by COMMISSARY OWNER/OPERATOR <br /> Bu, P.- o - q <br /> lof era Iu! kio- <br /> eDWYAi5C <br /> eL f ya <br /> Check all <br /> 3-GOITIDTUPPrIt sink ;11 Electrical book-upsy =14 <br /> 0 31 Fcod pry?parwton J9 "miet arxi yv-.- <br /> I-k-A& PL Store fpfrigotated. food 4 Potable.w@,el. <br /> 1.0 Store(Iry in Ovorniglit park0 Vehicle hash <br /> —oh%,stat"that[Ile inlorroaticn. I nav,+:)rcv:cled is cijrrerv.tits-,' in, <br /> -!qi, xlu' F-w Heallh&5alet Como If:h6 <br /> IN" 1t t1l1, -4 t� nlodiitec! cr <br /> �As a <br /> 3. To be completed by the ENV HEAL I H jurisdiction outside of San Joaquin <br /> ALAMEDA COUNTY <br /> flleCh., the <br /> tile <br /> 10/06/2023 <br /> if; E I Avelliv?I (Iollfumlo 9520 1 1 209 468-3420 1 F 4164-0--'A I <br />