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File# COMMISSARY AGREEMENT *Completion of this Commissary Agreement is required prior to issuance of Solano County Permit.* Business Name Commissary Owner’s Name: Commissary Ownet^- CA Zip: Signature Operator: DateSignaturePrint Name [ ] Food preparation Potable water supply Food product supplier Jxj' Restrooms I certify that, to the best of my knowledge, the above information is true and that I will comply with all applicable local, city, county, and state requirements. ^4 Utensil washing [ ] Dry food storage jX Liquid waste disposal X Vehicle / cart storage [ ] Refrig. I frozen food storage [ ] Supply /equipment storage Electrical hook-up Jxf Garbage disposal Trey Strickland Environmental Health Manager County. NO (explain below): Name of business providing restroom facility during hours of operation: Business Name:. Address: City:. Environmental Health Division (707) 784-6765 Department of Resource Management 675 Texas Street, Ste. 5500 Fairfield, CA • 94533 www. so la n ocou nty .co m Food establishment / commissary is located outside Solano County: The food establishment / commissary is located in The above establishment is in good standing with the local E.H. Department? jx^YES Date to/ z,-?/ Date z.Out of County REHS: Print Name lager 1/ Type of Facility: Market Restaurant Warehouse Other: I, the commissary owner/operator, agree to provide the necessary facilities for the above mentioned vehicle at my peimitted facility as checked below: I agree to notify Solano County Environmental Health of any change in the status of my operation or w hen this commissary agreement is no longer valid. A copy of the current health permit is provided. Telephone: ~ 33 H <25 73 Commissary Name: t! GA Ctw'iesary Commissary Address: 355 U;. CA, AfeerAo