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S A N J 0 fl Q I I I N Environmental Health Department <br />.—COU FNI_fY— <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 #: <br />MENU DESCRIPTION <br />Indicate all the food and beverage items for sale. <br />WHERE WILLTHE FOOD Be PREPARED? <br />FOOD ITEM <br />COMMISSARY <br />ON-SITE <br />vxlo <br />A"0 r S <br />Erl <br />b(A o n 0 bosed t^I A <br />LIQ <br />12- <br />El <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 />_ y, <br />+o <br />T"v LJr- Q. /\�- <br />�0`(& yo k-eb <br />--o h 0 a aa <br />vxlo <br />A"0 r S <br />2 of <br />