Laserfiche WebLink
SKJOAQUIN <br />—COUNTY <br />Environmental Health Department <br />1. Indicate the location where you will store food and equipment at the end of thee, day. <br />CommissaryName:. `POS;tA1f& Kok <br />' M`er�ee t Facility ID tf: FAOOO 21 <br />5A <br />Address: Lt 15 Al, Y,5,P-v , tQ, <br />S"ZO <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 />�0 h-N,�w Ot w <br />T21 OWlbfitl�_rr\ <br />CvoV <br />o�,✓I sta ass <br />S <br />0 d. <br />`Nok foT <br />❑ <br />sl3u� <br />E�r' <br />❑ <br />YojaSA <br />Cr' <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 />f�V <br />l..�Ovf°' <br />�'\TJ 0 W <br />�0 h-N,�w Ot w <br />T21 OWlbfitl�_rr\ <br />CvoV <br />o�,✓I sta ass <br />CI <br />Stolt'N <br />0 d. <br />`Nok foT <br />geM <br />� MU/ <br />Cto tX"A Zs)z/liC_ <br />4A4 <br />WOS IA q 4IJ5 <br />2 of 4 <br />