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JA N J 0 A, ;; ; S � � Environmental Health Department <br /> COUNTY <br /> Food Production <br /> 1. Indicate the location where you will store food and equipment at the end of the day. <br /> Commissary Name: , l N r 6/6 C16P,4 C, �R UO(LCN��Facility ID#: <br /> Address: l I s c1lk)16/ 5i S-EkA Ch 2S�E <br /> MENU DESCRIPTION <br /> Indicate all the food and beverage items for sale. WHERE WILL THE FOOD BE PREPARED? <br /> FOOD ITEM COMMISSARY ON-SITE <br /> Dkrwt, C401A ,cam, ❑� V <br /> ❑ ❑ <br /> ❑ ❑ <br /> 2. List equipment and utensils that will be used. Please be specific on equipment's use and function. <br /> For example: Equipment: Blender Intended use: Make Smoothies <br /> Equipment Intended use during food preparation or catering event <br /> Refrigerator <br /> 4rAi�� <br /> _'of4 <br />