Laserfiche WebLink
7(2_0 <br />COMMISSARY AGREEMENT 002-kiSSI <br />Mobile Food Facility Caterer <br />Complete sections <br />1 and 2. If your commissary is located outside of San Joaquin County also complete section 3. <br />1 . j bqc_orriptq_ted by}R,PLICANT <br />SALVADOR BUENROSTR <br />DBA CALIFORNIA CATERING TRUC <br />730 S CALFORNIA ST <br />STOCKTON. CA 95203 <br />tip-o*SAN MOWN E nvironmental Health Departmen 0 Ni I Y <br />;44w4reilitsi h <br />Business Name Mr. B I. s BBQ <br />Owner/Operator Namesean H uino <br />Business Mailing Address 1483 Brid e ort Lane _ <br />City Manteca State CA Zip 95336 Bus. Ph. 209-846-5383 <br />1, <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 />commissary is discontinued, the permit holder must notify the EHD. Failure to notify this office may result in permit ievocation anct\penaltie <br />Lic. Plate # 4SU7938 <br /> <br />Alt. Ph. <br />Z.Vat\a't.lAT <br />Date 4/3/2025 <br />by COMMISSARY OWNER/OPERATOR C"tiliS r\J Nat, AcIrit%% <br />California Caterin Truck VVash City_ Californi PAAe 209-404-9707 a‘k Zi Bus. Phone 209-271-1741 Ch ,...‘ot,rkeete, serv,ce:rovided: O wner/Operator Salvador Buenrostro & Carrneri F?ive <br />13 Solid waste disposai t KZ Electrical hook-ups <br />C:t 3-compartment sink <br />Er Food preparation <br />67 Toilet and handwashing <br />121 Hot & Cold water for cleaning <br />Ei3 Store dry food/supplies <br />I, <br />correct to the best of my knowledg <br />operator fails to <br />, <br />c ply with the 7n <br />commissary ow er shall notify t <br />Signature <br />Et Overnight parking D Vehicle wash <br />hereby state that the information I have provided is current. true and <br />e.ondidon and meets the California Health & Safety Code requirements. If the food facility <br />EHD immediate <br />s o this .••reement, or if <br />this agreement is modified or cancelled. the <br />GI Store refrigerated food la Potable water <br />Date 4/3/2025 <br />y the EN HEALTH jurisdiction outside oLSa____n_____42e The commissary is located in uin Co. acboomvmeicsosmarymi requirements Ca— County. The above food facility meets the l-ifornia Health & Safety Code. The above checked services are available at the <br />— <br />ssary. Please notify EHD if the <br /> status of their operating permit changes. REHS Signature <br />Date_ <br />1868 E. Hazelton Avenue I Stockton, California 95205 I 1 209 468-3420 I <br />F 200 464 -0138 I www.sigov.orgiehd <br />L,_:_a _b_e_c__o_mple te