Laserfiche WebLink
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 />4XG5094Lie. Plate # <br />7/30/26Date <br />FA# 209-464-9707 <br />209-271-1741 <br />95203Stockton <br />Vehicle wash <br />7/30/26Date <br />Date REHS Signature <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />V Electrical hook-ups <br />v Toilet and handwashing <br />Potable water <br />SAN JOAQUIN <br />------COUNTY------ <br />2. To becompleted by COMMISSARY QWNER/QPERATOR <br />____________ <br />HEALTH jurisdiction outside of San Joaquin Co. | <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 />California Catering Truck Wash <br />_________Bus. Phone <br />Owner/Operator Salvador Buenrostro & Carmen Rivera <br />O3A CALIFORNIA CATLING TOW WASH <br />' 30 S CALFORNIA ST <br />COMMISSARY AGREEMENT Rockton,ca95203 <br />Mobile Food Facility ♦ Caterer <br />Commissary Name <br />Address 730 S California St <br />Business Name Savi's LLC <br />Owner/OperatorName Sri Anjaneya Suresh Dronavalli <br />Business Mailing Address 1314 S Cow Ct <br />City MTN House StateCA Zip 95391 Bus. Ph. 510-378-8547 A|t <br />I,^V i r? n Sj-rjz-f^rAW-^l^reby state that the above information is current, true and correct to <br />the best 'or 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 />qS <br />Signature / <br />City Stockton Zip <br />Check all appropriate services provided: <br />g Wastewater disposal 3-compartment sink <br />B Solid waste disposal Food preparation <br />B Hot & Cold water for cleaning Store refrigerated food <br />3 Store dry food/supplies Overnight parking <br />I,______________________, hereby state that the information I have provided is current, true and <br />correct to the bes^of my knowledge^and meets the California Health & Safety Code requirements. If the food facility <br />operator fails tpYomply with the/conditions of thisy^reement, or if this agreement is modified or cancelled, the <br />commissary q&r/er s|iall notifwtne EHD immediately/ <br />Signature / // <br />3. To be completed by the EN