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Lic. Plate # 4WG7506 <br />r .1 <br />SANIJOAOUIN <br />--COUNTY <br />. Greotness grows herr <br />Environmental Health Department <br />SALVADOR BUENROSTRO <br />09A CAUFORNIA CATERING TRUCK wASH COMMISSARY AGREEMENT 730 S CALFORNIA ST <br />Mobile Food Facility • Caterer <br />Complete sections 1 and 2. If your commissary is located outside of San Joaquin County also complete section 3. <br />APPLICANT <br />Business Name DES! TASTE OF INDIA <br />Owner/Operator Name GURDIAL SINGH <br />Business Mailing Address <br />City TRACY <br />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 San Joaquin County Environmental Health Department (EHD) requirements. If the use of the <br />revocation and nalties. commissary is discontinued, the permit holder must notify the EHD. Failure to notify this office may result in permit <br />7 ii Signature <br />Check all appropriate services provided: <br />City Stockton <br />Zip <br />95203 <br />Address 730 S California St <br />Commissary Name California Caterin Truck Wash <br />' 2. To be com leted b COMMISSARYMWNER/OPERATOR <br />Owner/Operator Salvador Buenrostro & Carmen Rivera <br />Bus. Phone 209-271-1741 <br /> Date 10/1/2024 <br />FA# 209-464-9707 <br />gt Wastewater disposal <br />12 3-compartment sink Er Solid waste disposal a Food preparation <br />Hot & Cold water for cleaning <br />Er Store refrigerated food <br />Store dry food/supplies 13 Overnight parking <br />i, Cr 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 commissa wner s a notify the EHD i ediately. <br />Signature <br />Date 10/1/2024 <br />e completed bilhe ENV HEALTH jurisdiction outside of San JoacCo. <br />The commissary is located in <br />County. The above food facility meets the commissary requirements in California Healthg Safety <br />e. The above checked services are available at the above commissary. Please notify EHD if the status of their operating permit changes. <br />RENS Signature <br />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 />San Joaqun County <br />Assessor/Recorder/County Clerk 277 (01/2019) <br /> <br />17 0 nc 1 TN. --' <br /> <br />Original- Recorder <br /> <br />Yellow-Newspaper Pink. Cuabiner <br />STOCKTON, CA 95203 <br />1243 MONTGOMERY LN <br />State CAZip 95377 Bus. Ph. 5598855956 <br />12 Electrical hook-ups <br />Et Toilet and handwashing <br />a Potable water