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SAN _JOAQUIN <br />—COUNTY <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: <br />Address: <br />`. Facility ID f!: <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 />ON-SITE <br />�a <br />L�-tJ[}-,I <br />cyo- <br />UM,-> I I ►� <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 />�y� <br />(� 111 <br />(� <br />D� � C <br />�a <br />A s <br />2of4 <br />111 <br />