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SANJOAQUIN Pnvironmentai Health Deparl <br />COUNTY <br />COMMISSARY AGREEMENT <br />Mobile Food Facility Caterer <br />SALVADOR BUENROSTRO <br />DBA CALIFORNIA CATERING TRUCK WASH <br />730 S CALFORNIA ST <br />STOCKTON, CA 95203 <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 />Business Name El Yaguelo Hot Dogs Lic. Plate # 4EZ8716 <br />Owner/Operator Name Israel Camacho <br />Business Mailing Address 1731 Autumn Lane <br />City Escalon State CAZip 95320 Bus. Ph. 209-592-6091 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 /> <br />Date 3/18/24 <br /> <br />2. To be completed by COMMISSARY OWNER/OPERATOR <br />Commissary Name California Catering Truck Wash FA# 209-464-9707 <br />1, <br />City Stockton Zip 95203 Owner/Operator Salvador Buenrostro & Carmen Rivera <br />Check all appropriate services provided: <br />Bus. Phone 209-271-1741 Address 730 S California St <br />Wastewater disposal <br />:V Solid waste disposal <br />Hot & Cold water for cleaning <br />Store dry food/supplies <br />61 3-compartment sink <br />14 Food preparation <br />Er Store refrigerated food <br />Er Overnight parking <br />D' Electrical hook-ups <br />CZ Toilet and handwashing <br />ET Potable water <br />Er Vehicle wash <br /> , hereby state that the information I have provided is current, true and <br />correct to the best of my knowledge, and meets the California Health & Safety Code requirements. If the food facility <br />operator fails to compl with the co itions of this agreement, or if this agreement is modified or cancelled, the <br />commissary owner shf notify the P immediately. <br />Signature <br />leted by he ENV 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 />RENS Signature Date <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.orgiehd <br />t4522-1-W <br />Date 3/18/24