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 />4VE2221Lie. Plate #Business Name Mextamales <br />Alt. Ph. <br />12/19/25Date <br /> <br />FA# 209-464-9707 <br />209-271-1741 <br />Owner/Operator Salvador Buenrostro & Carmen Rivera95203Stockton <br />Date 12/19/25 <br />Date REHS Signature. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 Jwww.sjgov.org/ehd <br />comply witl <br />ler shall no# <br />□' Electrical hook-ups <br />O' Toilet and handwashing <br />Q Potable water <br />S' Vehicle wash <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 />City Stockton Zip. <br />Check all appropriate services provided: <br />q Wastewater disposal ET 3-compartment sink <br />B Solid waste disposal <br />Q Hot & Cold water for cleaning <br />0 Store dry food/supplies <br />I,____________._________ <br />correct to the be^yof my knowb <br />operator fails <br />commissary c <br />Signature I <br />COMMISSARY AGREEMENT ... <br />Mobile Food Facility ♦ Caterer <br />California Catering Truck Wash <br />Bus. Phone <br />B0a^~caSSWASh <br />STOCKTON, CA 95203 <br />' ^§MAN»)0A()UIN <br />\ y —county— <br />Greotness growi here. <br />Commissary Name. <br />Address 730 S California St <br />Owner/Operator Name Jesus Mateo Reyes <br />Business Mailing Address 639 S Wagner Ave <br />City Stockton StateCA Zip 95215 Bus. Ph. 209-451-7790 <br />I,, hereby state that the above information is current, true arid 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 />O' Food preparation <br />ET Store refrigerated food <br />S' Overnight parking <br />J___, hereby state that the information I have provided is current, true and <br />a^e, and meets the California Health & Safety Code requirements. If the food facility <br />ne conditions gf4his agreement, or if this agreement is modified or cancelled, the <br />the EHD imn^oiately.