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Environmental Health Department <br />■"’F* <br />Complete sections 1 and 2. If your commissary is located outside of San Joaquin County also complete section 3. <br />APPLICANT1Tooecc <br />Business Name Caminos De Fe 8V30130Lie. Plate# <br />Alt. Ph. <br />9/30/25Date <br />®CO <br />California Catering Truck Wash FA# 209-464-9707 <br />209-271-1741Bus. Phone <br />Stockton 95203 Owner/Operator Salvador Buenrostro & Carmen Rivera <br />O' Vehicle wash <br />Date 9/30/25 <br />REHS Signature Date <br />O’ 3-compartment sink <br />Q Food preparation <br />ET Store refrigerated food <br />O' Overnight parking <br />O' Electrical hook-ups <br />O' Toilet and handwashing <br />S’ Potable water <br />SALVADOR BUENROSTRO <br />DBA CALIFORNIA CATERING TRUCK WASH <br />730 S CALFORNIA ST <br />STOCKTON. CA 95203COMMISSARY AGREEMENT <br />Mobile Food Facility ♦ Caterer <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />SANJOAQUIN <br />I ------COUNTY------ <br />Greatness grows here. <br />Owner/Operator Name Ana Lucia Lagunas Canales <br />Business Mailing Address 6818 Kilamanjaro Way <br />City Stockton StateCA Zip 95219 Bus. Ph. 209-251-5036 <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 <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 />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 to comply with the conditions of thia^greement, or if this agreement is modified or cancelled, the <br />commissary cwner shall notify the EHD immgfiHcitely. <br />S ignatu re J <br />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 />by COMMISSARY OWNER/OPERATOR <br />Commissary Name <br />Address 730 S California St