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Environmental Health Department <br />COMMISSARY AGREEMENT <br />Mobile Food Facility 4 Caterer <br />SALVADOR BUENROSTR <br />DBA CALIFORNIA CATERING TRUChTSH <br />730 S CALFORNIA ST <br />STOCKTON, CA 95203 <br />SANAOAQUIN <br />—COUNTY— <br />Greotness grows here. <br />Complete sections 1 and 2. If your commissary is located outside of San Joaquin County also complete section 3. <br />Business Name El Patron Sabor A Mexico Lic. Plate # 70306B2 <br />Owner/Operator Name OMMAR GONZALEZ <br />Business Mailing Address 24 W JAMESTOWN ST 303 <br />City STOCKTON State CA Zip 95207 Bus. Ph. 5105002449 Alt. Ph. <br />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 <br /> Joaquin County Environm Health Department (EHD) requirements. If the use of the <br />commissary is dis oritinued, the per holder otify the EHD. Failure to notify this office may result in permit <br />revocation and p lties. <br />Signature Date 2/27/23 <br />Commissary Name California Catering Truck Wash <br />Address 730 S California St <br /> <br />FA# 209-464-9707 <br /> <br />Bus. Phone 209-271-1741 <br /> <br />City Stockton Zip 95203 Owner/Operator Salvador Buenrostro & Carmen Rivera <br />Check all appropriate services provided: <br />12 Wastewater disposal <br /> 12 3-compartment sink <br /> Electrical hook-ups <br />Ef Solid waste disposal <br /> Food preparation Toilet and handwashing <br />El Hot & Cold water for cleaning <br /> 17 Store refrigerated food <br /> <br />Et Potable water <br />El Store dry food/supplies <br /> <br />Er Overnight parking <br /> <br />Er Vehicle wash <br /> 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 />commissaryi owner s all notify the EHD i ediately. \ j <br />4171,7,,;*Irt <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 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />1, <br />Signature <br /> <br />4/1A,W1 <br /> <br />Date 2/27/23 <br /> <br />PR09-{0249--