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SANJ OAQ U I N Environmental Health Department <br /> —COUNTY— <br /> • • • Production <br /> Indicate the location where <br /> Ayou <br /> �will store <br /> rfood <br /> ,^and equipment at the end of the day. <br /> Commissary Name: \e h Q 1 V Oid U u � l�-V M Facility ID#: <br /> Address: <br /> Zsq 5 . C� Ut(�I eve _3t t +e L ud C� �SaH a <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 /> �GI V�Imp ® El <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 /> Coo( k01d, VI(_0 � cl�.eese, �k�(tvk cid +iv kWtktA- <br /> Mlxer V-KDf� Tor coomkA + eyeam thr � iraWtlso- <br /> Fv eV, Fr I V11A Cov�vv()UL Skce veS <br /> �vev1 jaki'►n Vici7t1(l� ca_k <br /> shvc fcy H OL �, V i Co m <br /> v-4n ►teal cS+orty� Vico-Ro. <br /> �f VVI "I-or rico c.- Lu-V� <br /> (_&NWL S Fo\- fr i M caAG,O h <br /> Geese cloth ole Maka <br /> V\q vicoikio, 6kev_) <br /> ?of4 <br />