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SANJ O A Q U I N Environmental Health Department <br />I-OUNTY <br />1. Indicate the location whrere/ yyou, will store food and equipment at the end of the day. /N % <br />cL �,Oleo <br />Commissary Name: 1 1 YVI 1 ITCMI �' ih ►r' oS Ca l0 u/ u <br />Address: <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 />r <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 />/ <br />/V <br />r717 164 S <br />r <br />�.fA <br />