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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 />1. To be completed by APPLICANT <br />Lie. Plate#4WR9418 <br />Alt. Ph. <br />2/26/26Date <br />2. To be completed by COMMISSARY OWNER/OPERATOR <br />FA# 209-464-9707California Catering Truck Wash <br />209-271-1741Bus. Phone <br />Owner/Operator Salvador Buenrostro & Carmen RiveraStockton95203 <br />S' Vehicle wash <br />Date 2/26/26 <br />V HEALTH jurisdiction outside of San Joaquin Co. j <br />Date PENS Signature. <br />Q Electrical hook-ups <br />Et Toilet and handwashing <br />S Potable water <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 />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />^ISANJOAOUIN <br />r) COUNTY— <br />Greatness grows here. <br />Owner/Operator Name Esdras Diaz______________________________ <br />Business Mailing Address 2048 West Euclid Ave <br />City Stockton StateCA Zip 95204 Bus. Ph. 510-500-2140 <br />I, CzS S 7/^ , 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 oermit holder must notify the EHD. Failure to notify this office may result in permit <br />revocation and penalties. <br />Signature <br />730SCALFORNIAST ” <br />COMMISSARY AGREEMENT stockton,ca95203 <br />Mobile Food Facility ♦ Caterer <br />Commissary Name <br />Address 730 S California St <br />O' 3-compartment sink <br />GJ Food preparation <br />O' Store refrigerated food <br />ET Overnight parking <br />, here>fy state that the information I have provided is current, true and <br />California Health & Safety Code requirements. If the food facility <br />City Stockton Zip <br />Check all appropriate services provided: <br />Q Wastewater disposal <br />0 Solid waste disposal <br />E3 Hot & Cold water for cleaning <br />0 Store dry food/supplies <br />I,___________________________ <br />correct to the best of my knowledge, and meets tl <br />operator fails tcrcomply wittf the conditions obf^is agreement, or if this agreement is modified or cancelled, the <br />commissary owner shall notifWthe EHD immediately. <br />Signature <br />|3. To be completed by the <br />Business Name Oui So Sweet LLC