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SAN JOANN <br />Environmental Health Department <br />1. Indicate the location where you will store food and equipment at the end of the day. <br />Commissary Name: V-)Yfj �—OA � iA � %^ '�, <br />Address: <br />Facility ID q: <br />MENU DESCRIPTION <br />Indicate all the food and beverage items for sale. <br />WHERE WILL THE FOOD BE PREPARED? <br />FOOD ITEM <br />COMMISSARY <br />ONS --SITE <br />QI p <br />E]Iz <br />i 1+nch5 S711�t1 <br />�n8s <br />�0/,PAtool <br />❑ <br />❑ <br />ftci <br />a <br />❑ <br />❑ <br />❑ <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 <br />Intended use during food preparation or catering event <br />Refrigerator <br />L <br />i 1+nch5 S711�t1 <br />�n8s <br />J t <br />2 of <br />