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1 and 2 <br />>leted be. PW«*.Ki <br />i <br />.Date.REHS Signature <br />1663 E Hawton Avenue | Stockton. Cakfonua 952051 T 209 468-34201 F 209 464-0138 | <br />__i <br />[SWtfflN <br />M <br />Q Eledrical hook-ups <br />Q Toftet and handwashing <br />B Potable water <br />0 Vehicle wa&h <br />_______Bus Phone. <br />Owner/Operator' <br />■ \ I <br />ontal Health Department <br />Environment <br />W-'COU^Y^ <br />?<5" cokmss«^!SENT Z .1 <br />, Tobe«,n»S^^® <br />Pi Coyote YSuTopaJ^. <br />BUMne«H*T*l^——-------------------------- <br />O^tOperatorNam ----, <br /> ———7■ <br /> c^^7r~M;XTzl— <br />cornmnsary m daco<nir>uB<^JW WII _ - L . / n r- <br />n^ocaeon and p«nan>«* / J _________ _______Dale 05/0/ ( ------------- <br /> <br />Scnawra----------------\—______ -=--------“ ------------- <br />.^neted by CO®SSARYOWNE^PE^QR <br /> <br />Comnusssry Name^l^!21i£-----------------------,,.. 209-338-3663 ------ <br />jwdr^«1211 S 7th Street__________ __________Bu» Hhono— — <br />--------------^^aratorWlhanLBer^_____ <br />Check all appropriate services provided <br /> Wastewater disposal <br />B SoW waste disposal <br />B Hot A Cold water for cleaning <br /> Store dry food/suppbes <br />, Mark Lms Cruz <br />D ^compartment sink <br /> Food preparation <br /> store refngerated food <br /> Overnight parking <br />hereby state that the infonnatton I have provided is current, vu« and <br /> XZT_______ pate OS/o'/jf-------------- - <br /> 3 - ( , , ^npieteu , • r. -J TH jurisdiction outside of San Joaquin Co.j <br />The commusarv is located in County, the above food taolfty meets the <br />conwwwy requirements in Californra Health i Safety Code The above checked services are available at the <br />above commiswy Please notify EHD If the status of their operating permit changes