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SAN 10 A Q U 1 N Environmental Health department <br /> COUNTY SALVADOR BUENROSTRO <br /> DBA CALIFORNIA CATERING TRUCK WASH <br /> 730 S CALIFORNIA ST <br /> STOCKTON, CA 95203 <br /> COMMISSARY AGREEMENT <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 /> 1 . To be completed by APPLICANT <br /> Business Name DAPPER DOGS Lic. Plate# 1 EM5060 <br /> Owner/Operator Name RICHARD MARK MCCLOSKEY <br /> Business Mailing Address 212 E HARPER ST <br /> City STOCKTON State CA Zip 95204 Bus. Ph. 209-9225136 Alt. Ph. <br /> I, , 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 /> commissary is discontinued, the permit holder must notify the EHD. Failure to notify this office may result in permit <br /> revocation and penalties. � <br /> Signature ��` Date 4/16/2025 <br /> 2. To be completed by COMMISSARY OWNER/OPERATOR <br /> Commissary Name California Catering Truck Wash FA# 209-464-9707 <br /> Address 730 S California St Bus. Phone 209-271-1741 <br /> City Stockton Zip 95203 Owner/Operator Salvador Buenrostro & Carmen Rivera <br /> Check all appropriate services provided: <br /> Q Wastewater disposal 12 3-compartment sink 9 Electrical hook-ups <br /> Ej Solid waste disposal 12 Food preparation 12 Toilet and handwashing <br /> 63 Hot & Cold water for cleaning Q' Store refrigerated food G Potable water <br /> El Store dry food/supplies Q' Overnight parking Q' Vehicle wash <br /> I, , 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 comply ith the conditions c this agreement, or if this agreement is modified or cancelled, the <br /> commissary ner shat n tify the EHD immeV <br /> ely. <br /> signature Date 4/16/2025 <br /> 3. To be completed by the ENV HEALTH jurisdiction outside of San Joaquin Co. <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 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br />