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SANJOAQUIN <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: Rfver Rood rrodwcc Facility ID H: <br />Address: 25180ERiver Road ESCaIOn CA C15320 <br />MENU DESCRIPTION <br />Indicate all the food and heverage Items for sale. <br />WReat wiu rHr rood BE vaernaeo? <br />FOOD ITEM <br />COMMISSARY <br />ON-SITE <br />Cheese — Cud <br />Ctti} fvu & — -FDD d Pt-eP a raih an <br />❑ <br />Cold cuts/ ry.ect+ - 14nfgGka9e. and Fold <br />Er <br />❑ <br />fnnrl�s w Veyek WCS — wash qr,a ckf <br />d <br />❑ <br />Bread, CrAc}ttrs, nuts , honey, Darn — open <br />❑ <br />Q� <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 />AD keel` all fo0d a� Pvnl`eri-empera IAre / befwcry of4c as <br />cheat k-nl k <br />C%+ the tSe -Food prepa na-hv) <br />fru rt Kn i�{, <br />Ctti} fvu & — -FDD d Pt-eP a raih an <br />culhriy boar -ds <br />cL4+ Tvtlt- qnd chtese - food Prf_fara-f ITn <br />s*alner <br />si'mln wader fwm -ivu+ �, veg6ables af-l-rr wusk <br />alln leaf P1atcs <br />10 P1ePare fVOA on <br />Peep +Table <br />10 prepare Ct,U -Foot{ oo <br />2 of 4 <br />r <br />ttbly <br />