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f* <br />11874T3Lie. Plate# <br />Alt. Ph. <br />9/26/25Date <br />California Catering Truck Wash FA# 209-464-9707 <br />Stockton 95203 <br />O' Vehicle wash <br />Date 9/26/25 <br />Date REHS Signature <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 I www.sjgov.org/ehd <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 />□' Electrical hook-ups <br />GZ Toilet and handwashing <br />O' Potable water <br />Environmental Health Department <br />SALVADOR QUeNROffTRO <br />________Bus. Phone 209-271-1741 <br />Owner/Operator Salvador Buenrostro & Carmen Rivera <br />DfJA CALIFORNIA CATERING TRUCK WASH <br />730 3 CALFORNIA ST <br />STOCKTON, CA 95203 <br />City Stockton Zip. <br />Check all appropriate services provided: <br />Q Wastewater disposal <br />0 Solid waste disposal <br />0 Hot & Cold water for cleaning <br />0 Store dry food/supplies <br />L.__________________________ <br />COMMISSARY AGREEMENT <br />Mobile Food Facility ♦ Caterer <br />Comp/efe seeffons 7 and 2. /f your commissary is located outside of San Joaquin County also complete section 3. <br /> <br />Business Name Don Rafa's Taco Shop <br />Owner/Operator Name Rafael Castillo Estrada <br />Business Mailing Address 1248 E Miner Ave <br /> City^ Stockton StateCA Zip 95205 Bus. Ph. 209-829-8539 <br />I, tyViW C(A\hl(O ____, 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 <br />Commissary Name. <br />Address 730 S California St <br />SANJOAOUIN <br />-----COUNTY------ <br />Gredtneu grew here. <br />O’ 3-compartment sink <br />O' Food preparation <br />0 Store refrigerated food <br />0 Overnight parking <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 tc/comply with the z$nditions of this agfeement, or if this agreement is modified or cancelled, the <br />commissary ownfershall notify tttgEHD immediately: <br /> <br />Stature [ <br />13. To be* completed4)y the ENv HEALTH jurisdiction outside of San Joaquin Co.