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Environmental Health Department <br />Complete sections 1 and 2. <br />Lie. Plate # 37299L1 <br />Date 5/15/2025 <br />5/15/2025Date <br />REHS Signature Date <br />If your commissary is located outside of San Joaquin County also complete section 3. <br /> <br />1. To be completed by APPLICANT <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />fKOSMSWS}- <br />SAN JOAQUIN <br />------COU NTY------ <br />Grtetitess grows Aiere. <br />S' 3-compartment sink <br />O' Food preparation <br />O' Store refrigerated food <br />S' Overnight parking <br />____, hereby stS <br />ge, and meets the Califon <br />f conditions of this i <br />'"HD immediatebz <br />£3' Electrical hook-ups <br />O' Toilet and handwashing <br />S' Potable water <br />O' Vehicle wash <br />34hat the information I have provided is current, true and <br />ia Health & Safety Code requirements. If the food facility <br />Yjrement, or if this agreement is modified or cancelled, the <br />FA# 209-464-9707 <br />Bus. Phone 209-271-1741 <br />Owner/Operator Salvador Buenrostro & Carmen Rivera <br />Business Name Curry On Wheelss <br />Owner/Operator Name Bindiya Rani <br />Business Mailing Address 2753 Pine Brook Dr, <br /> <br />City STOCKTON State CA Zip 95212 Bus. Ph. 510-359-9999 Alt. Ph. <br />J’-—-— ------------------------------------------------■ 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 />~2. To be completed by COMMISSARY OWNER/OPERATOR <br />Commissary Name California Catering Truck Wash <br />Address 730 S California St <br />City Stockton Zip 95203 <br />Check all appropriate services provided: <br />S Wastewater disposal <br />Solid waste disposal <br />S? Hot & Cold water for cleaning <br />0 Store dry food/supplies <br />I, <br />correct to the best of my knowled <br />operator fails to/tomply with tb<S <br />commissary confer shall noti^thp-EHD immedi, <br />Signature Z // / <br />j/Jb be completed by the 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 />COMMISSARY AGREEMENT STOCKTON, CA 95^3 <br />Mobile Food Facility ♦ Caterer