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S A N sJ O A Q U I N Environmental Health Department <br /> COUNTY— <br /> Food <br /> OUNTY • • • Production <br /> 1. indicate the location where you will store food and equipment at the end of the day. <br /> CommissaryName: d e4� & R z Za Facility ID#: <br /> Address: jO th 4 T-rw-4 G,4 GIS 57 <br /> MENU DESCRIPTION <br /> Indicate all the food and beverage items for sale. WHERE WitLTHE FOOD BE PREPARED? <br /> COMMISSARY ON-SITE <br /> FOOD ITEM <br /> POr� Y��S ® ❑ <br /> [led �h <br /> Po_� 6d(y 694rh0hJ5 K1 F-1 <br /> fiurke U� 5�' ® ❑ <br /> !! El ❑ <br /> S U-tQ12ca� �Y�r�-wurs <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 /> e[ �L Lmw 4414- No 4- tic Side_ yt,S4 i-eS Abow- <br /> C fA'!t� i701q� � Su�G �-Y'�!n'I N'►r !'L�CIrTS <br /> 2 of 4 <br />