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SAN JOAQUIN <br />-COUNTY--- <br />1. Indicate <br />Commissary Name: <br />Address: <br />Environmental Health Department <br />location where you will store food and equipment at the end of the day. <br />Nab 1'1+ Da 9S /�L Facility ID q: <br />dal -17 S-7- , Ina4l�/cc. , l rl 9 3310 <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 />ESQ r S s o <br />4ch l #'7 e. <br />�k �Grt�+ <br />Zrlln f <br />or ,rte . <br />so De -1 <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />Ji e- <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 />/0 /7 G� 11-7 / /k <br />s aIDI',,, <br />ESQ r S s o <br />4ch l #'7 e. <br />�k �Grt�+ <br />Zrlln f <br />or ,rte . <br />so De -1 <br />Ji e- <br />2 of <br />0 4— <br />