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SAN:JOAQUIN <br /> Environmental Health Department <br />COUNTY <br />Food Production <br />Indicate the location where you will store food and equipment at the end of the day. <br />Commissary Name: ank-0,1 V cklIty <AchtnS Facility ID #: <br />Address: 2s-9 C-,oi Aye!, A , Luti , ch c1s-DJ-10 <br />MENU DESCRIPTION <br />Indicate all the food and beverage items for sale. WHERE WILL THE FOOD BE PREPARED? <br />FOOD ITEM <br />COMMISSARY ON-SITE <br />KULA— Go flr' I — -it p , c IA i CkCn 1 12_-1 , 171 <br />• o-kl-O Sal M <br />G re en SR \Ckd chpen° <br />E vO, L 71 X <br />ck_ 1,01"" N El <br />ri <br />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 />Refrigerator 1 , <br />igiPinoc <br />-d4)cv-1- ct)) cdac-,),, 11'nqra CQIc <br />J -1--) i rao-i- k_t CNN t)n c <br />i, <br />y -() Cork-, <br />Smektr ga-frEis 1-t CO,,._. Sivokc) Ilk.M.4- <br />4c.k ,Ik:e.cly\tr 1-0 kp yvkla-4- Lmnyl tdillc csQ.r vih <br /> ro ke'eP SR.IRD\ cDol <br />1)W,:4;nk-o\aZen Te (KASh \/\an s Cvrin t oen.4-- <br />6 co4in A fp -,\jc ,a WO1/47\--- R..----Q,/ 1-I- 1-S C/Ohe (910i6hq <br />,00A hvG6- l'(\ C&Vt'c 14- iS S\ic_erA_, i <br />clf\ck.,(-\• 011 -ro ,p1a.c2E, salad\b 1r) 0-k-tr tpck_vcf ,e0L <br />koMs ,i -ren5S CO-- rvkka:-\---- okn A -It, S,er0e_ ---ood <br />Gficktit_ —0 1\\,\0.\-1(\o-- t,iy CCek_ kuti-- <br />2 of 4