Laserfiche WebLink
SANJOAQUIN F,ivironrnotita Hnilth Dopartnumt <br />r•m• <br />COMMISSARY AGREEMENT <br />Mob Jo Food Fac.tlity • Caterer <br />Co.paore. Rocca. • and 2 Fpour coornoodry a Waive outsado of Son Japan Covey Mao ar•np*Olo **Won 3 <br />UuIMSU Name Mt, $4 P.Jt-Glit,IL.-1LC 4:).4 LIC Piese • <br />owrierOperetor N5,n Dui cos 0catter5ik,- erteataTo <br />Bustoesa Mow* Atkins's SC. V V t1W...% SSA Nivea <br />Gay WA p1 CA Statie_Zo 4if_allIA_ Sus PS AK Ph <br />I.A-DA& "61.11 "Pain fi:› . horsey stets Iflat OM Maws Iresmaten Is CwwWW, Vas and award 10 <br />tha awl Oily k,,a+APAre mod apse io oats n, applowal comfroaary In accialliewa Callowas Hasa+ S. <br />Sealy Coda. and SW' Joaquin County Ermecrynerser Health Depaehrwal (EHO) Walalwal"alS 11Pli ass al •01 <br />mwenissary clawonlia.00. Wv permit holder await nobly Ow ENO logo, So nOdy callai gamy rowit vi penial <br />Syrup:al* P811/244a-ft Dess_ N/144.t. 0.4W nivacaton and <br />Cornmiasary Name Wrocoic•TOK Cr04OAA-)1,1eT V r-,TcrAll,a_FAS <br />Addrsitai cooRAtop WT T. Bus Phone (ava) 'Not - MO* <br />City lirGir...4CTo la zip 4.6 ao a C>ener;Operator LECAHUL CANT a-1-61 - C.C>Cco.H.aDelli. <br />Check au appropriate services wooded' <br />8) Wastewater 0,sposal pa 3-comportment sink St erectOcel hook-ups <br />a Solid WACO (Impose 0 FoOd ProParac'n Si Toilet sod hanctereshing <br />$11 <br /> <br />Not & Cold water for deetung ii Store re'rverated /cod cit Potable water <br />a Store dry food/supple' 0 CArere-gat-faar 0 Velveloweet.- <br />I LeOlgtil- CAST".-)..0 , rwirelay slats that the ilornat,cet ha.i. prove.w.1 .1 wrreret. true wv,t <br />coffee to Modest Col My knowledge, and meets Ma Cal lOwla Hoatth 6 Safety Cada teaunrwmants litho ttr(x1lacerty <br />operator il I I I . 3 I 0 COMpty with the oorklbons or Ms agrooment at tt thts astee•nonf ri mod And or cancened the <br />correntaluiry B nottfy EHD ,mtrodiatety <br />Signature <br />11111111111111111*i- <br />The convnisswy le located al MO above food tedlay meet* the <br />commissary requirements in C.alifornia He.ifth 8 Safety Code. The leery° er,oeited sepoues are avalebie M the <br />above commissary. Plisses needy EHD the status of their Clereting Permt chandas <br />RENS Signature Date <br />1868E Hazelton Avenue Maiden. C..iforn 96205 I T 209 468-3420 I F 2094840138 ems s,gov orr;:ohd <br />darr -11111*-- <br />Date egy//2/24- <br />5ca n <br />PKO 5+7 563