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SA N J O A Q U IN Environmental Health Department <br /> —COUNTY— <br /> • • • Production <br /> 1. Indicate the location where yyou will store food and equipment at the end of the day. <br /> Commissary Name:jCe,Ntra( b-ct at KIIu,Ae Facility�D#: <br /> Address: PI 5 Gvt N Ave. zaC c4 95da� <br /> MENU DESCRIPTION <br /> Indicate all the food and beverage items for sale. WHERE WILL THE FOOD BE PREPARED? <br /> _. COMMISSARY ON-SITE <br /> FOOD ITEM <br /> a ATOhi S4l40( !v ej(riw fvtChll4dti A" (c <aK ❑ / <br /> FV <br /> V05t, t 5 ❑ <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 { ftd e7we z-o1z ooh Coo <br /> �1 Xe Ke b f4cr For afb(e <br /> v t, tiac Ch�'CKe r) 55.f& <br /> �,h ve6joq ok&t K{e No eek fw- CoQ <br /> '�lih qh1 P�eQ ood fR�e oo�/ <br /> 2 of4 <br />