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SANsJOA UIN <br /> Q Environmental Health Department <br /> COUNTY <br /> cs Greatness 9rov%-s her.?. SALVADOR BUENROSTRO <br /> DBA CAUFORNIA CATERING TRUCK WASH <br /> 73o S CALIFORNIA ST <br /> COMMISSARY AGREEMENT STOCKTON,CA 95203 <br /> Mobile Food Facility ♦ Caterer <br /> Complete sections 1 and 2. !f your commissary is located outside of San Joaquin County also complete section 3. <br /> Business Name Las Prontas Lic. Plate# 4VF5841 <br /> Owner/Operator Name Brander Thaly Diaz & Joaquin Delgado San Juan <br /> Business Mailing Address 1148 Boardwalk Drive <br /> City Stockton StateCA Zip 95206 Bus. Ph. 209-851-5664 Alt. Ph. <br /> 1, , hereby state that the above information is current, true and correct to <br /> the best Lmyknowledge and agree to utilize my appro ed commissary in accordance with Califomia Health & <br /> Safety Can Joaquin County Environmenta a th Depart nt (i*HD) requirements. If the use of the <br /> commissatinued, the permit holder must not' th FHD ailure to notify this office may result in permit <br /> revocatioties. <br /> Signature S IC(Z Date 7/28/25 <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 /> 12 Wastewater disposal 12 3-compartment sink 12 Electrical hook-ups <br /> B Solid waste disposal I1 Food preparation 12 Toilet and handwashing <br /> 63 Hot & Cold water for cleaning U Store refrigerated food G Potable water <br /> Q Store dry food/supplies B Overnight parking B Vehicle wash <br /> 1, , hereby state that the information I have provided is current, true and <br /> correct to the best 907ny knowledge, and meets the California Health &Safety Code requirements. If the food facility <br /> operator fails to _ ply with conditionyiely. <br /> agreement, or if this agreement is modified or cancelled, the <br /> commissary ow r hall noti the EHD imm <br /> Signature Date 7/28125 <br /> The commissary is located in County. The above food facility meets the <br /> commissary requirements in Califomia 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.orglehd <br />