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Environmental Health Department <br />1. <br />Facility ID#: <br />Where will the food be prepared? <br />COMMISSARY ON-SITE <br />□ <br />io I'D dudt >□ <br />2. <br />Equipment <br />i <br /> Food Production <br />SANJOAQUIN <br />-------COUNTY------- <br />Commissary Name: <br />Address: H <br />/ <br />cur, C/n A amm <br />dtocc lah > -ubrcu^b^r. <br />drops and Cork (hnuds <br />blends prird-rrd, doir^h <br />ca ie h hd <do>nds rd / <br />.io..d di cj I nd rc-C ghwr <br />.... ______ d i/wkr- <br />~ caM} hd ddr dr Q/Chtr/'i C/irpldo <br />di'dr <br />~ did • <br />/derpi/rpridid/i.p) <br />I « . FOOD ITEM12>cviU/ mJi H li-t <br />(V\irv LWLtfe <br />ruacirs t da 7-er (xnd <br />d rbppdnci dcra/t/p <br />rded rlcnirh $ fi/or <br />_ _______________________________________________________________-. <br />DcwuvB U*’ll Ivv HFFf(Xc^ <br />f/S vd&jIy^vaI^v iaJi /u D^/ASfKk) <br />'ztr/mS <br />Refrigerator <br />, fjffle. Orbife.(\pnups <br />iniib-r <br />dYnjJz <br />hdn>} <br />craa^ W/^ <br />Me&ol | <<y 6e2 I*, umT XSAAAJ <br />foppbyp) <br />pa cucdarc’d <br />dPtaa^r, rnap/e> <br />p , c (Lrcred <br />chrirpes, Orro Cwr/M?Sj edc< <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 />Intended use during food preparation or catering event <br />Indicate the location where you will store food and equipment at the end of the day. <br />'bkuw p-.ldpjerdp <br />MENU DESCRIPTION <br />Indicate all the food and beverage items for sale.