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i,!noiogical Test (quarterly') <br />"4,trate Tost (yeady') <br />4 <br />Example: <br />BIG CAKE BAKER <br />1.1 9S-7.4 <br />to <br />Chocolate Chip Cookies with Walnuts <br /> <br />t •1C,, •,ff • ,41.0, 07 r • ..• <br /> <br />t 4 • 1., <br />e • e•, e• 14 , 4 f <br />, <br />L <br />04.1 <br />6. Disposal of Waste: <br /> <br />Plt.ase tope of Ifeatrrerr is used to dispose ol *aste <br />ac Sec Sor.ice Private Septic System <br />• olurntung poblom you are reau.red to natty San Joaquin County Environ.,- <br />Deponrimrit <br />7. Water Source: <br />ts,er -P2'y the nate( source to Do used in COndCre Food Facility (check one box) <br />P.ZAV: Viater SyVern or Community Sen./COS District 51' o .c ob <br />identify thesouri7....,weii.4.)nrig, surface. VC 1 <br />Prrva re Water Supply Initial Water QuallarReiatts <br />t*40v. if testing het been ourripleLe. <br />fr,..,st la, done e State Certified Latioariory Oler &tech Lab results or provosts Oartri7 <br /> <br />sult5 in pro.iidod nest to type attest. <br />.1 I e S 3 fregjereC,,of tran&Ant NOM.COtTyrtgAity yvater Sysitems prier iroitet 1444