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Name of MFF: <br />CP\ 051^0 <br />10590 Armstrong Avenue • Mather, California 95655 • fax (916) 875-8513 <br />Environmental Compliance (916) 875-8550 • Environmental Health (916) 875-8440 <br />www.saccounty.net • emd.saccounty.net <br />Out of County REHS Signature <br />^2- <br />Phone Number <br />/Av/2 io <br />Date <br />^9^1 <br />REHS number <br />i , > <br />Environmental Management <br />Department <br />Marie Woodin, Director <br />If the proposed facility is located outside of Sacramento County, the local Environmental Health <br />Department shall verify that the commissary and/or commercial kitchen has a current health permit by <br />signing below. The establishment is in County/City. <br />An REHS signature verifies that the facility indicated in above meets CALCODE Section 114294-114297. <br />r c b (o ’ 2- <br />Out of County REHS Name (Please Print) <br />OUT OF COUNTY COMMISSARY <br />W- <br />Name of Commissary: £U^^0 <br />Commissary Address: <br />'r/rfCS'L'i <br />Email Address