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Environmental Health Department <br />Complete sections 1 and 2. If your commissary is located outside of San Joaquin County also complete section 3. <br />Lie. Plate #11864T3 <br />9/29/25Date <br />Bus. Phone <br /> JDate—9/29/25 <br />REHS Signature Date <br />COMMISSARY AGREEMENT <br />Mobile Food Facility ♦ Caterer <br />Health & Safety Code requirements. If the food facility <br />mt, or if this agreement is modified or cancelled, the <br />O' Electrical hook-ups <br />Q Toilet and handwashing <br />ET Potable water <br />O' Vehicle wash <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />SANJOAOUIN <br />------COUNTY------ <br />Greatness grows here. <br />FA# 209-464-9707 <br />209-271-1741 <br />Owner/Qperator Salvador Buenrostro & Carmen Rivera <br />rsr.. SALVADOR BUENROSTRO <br />DBA CALIFORNIA CATERING TRUCK WASH <br />730 S CALFORNIA ST <br />STOCKTON, CA 95203 <br />EJ 3-compartment sink <br />O' Food preparation <br />S' Store refrigerated food <br />S Overnight parking <br />♦ <br />, hereby statejhat the information I have provided is current, true and <br />correct to the best of my knowledge, and meets the Califoi <br />operator fails to comply with the cenditions of this agj^i <br />commissary owner/ahall notify theTZHD immediately. Z/ <br />Si9nature—f/-vV\ iyi/M r ( <br />' 3: T° be completed by the ENV HEALTH jurisdiction outside of San Joaquin CoTI <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 />City Stockton Zip 95203 <br />Check all appropriate services provided: <br />Q Wastewater disposal <br />0 Solid waste disposal <br /> Hot & Cold water for cleaning <br />0 Store dry food/supplies <br />I,_____________________ <br />Business Name Curry on Wheelss <br />Owner/Operator Name Bindiya Rani <br />Business Mailing Address 10329 Bridqeqate Lane <br />City Stockton StateCA Zip 95219 Bus. Ph. 510-359-9999 Alt. Ph. <br />------------------------------------------------ ----------, 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 California Catering Truck Wash <br />Address 730 S California St <br />Stockton