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SA N J O A Q U I N Environmental Health Department <br /> COUNTY <br /> Food • • • <br /> 1. Indicate the locationwhereyou will store food and equipment at the end of the day. <br /> commissary Name: k�, ��P 11 rf �41 V1L— Facility ID p: <br /> Address: <br /> MENU DESCRIPTION <br /> Indicate all the food and beverage items for sale. WHERE xnuTHE FOOD BE PREPARED? <br /> FOOD ITEM COMMISSARY ON-SITE <br /> Cltreel hnezy, Chteks, Ftah Fw'J ❑ <br /> CkAVC _&qf y✓Lt21`n� box tityy;u, dklul Fieult mutt 'I l� <br /> CiAccerS, Hwo, jam <br /> Cuktd tntatt,Vkvkc Prahftit <br /> Ckarcl,t.hf '1t 91'2 ir7� bfit I�veyyl.s, rtNrd twit, nun, ce'W&I <br /> n& <br /> ❑ ❑ <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 Intended use during food preparation or catering event <br /> Refrigerator uSW b Soe Vornt7 9 Cka-re, F-"f4, Vfyy t-eJ -f <br /> pterated <br /> Cheese Kowes uLcd +� cur �htrs� <br /> Wive tr u Cut t? -ete <br /> tL lv 1 d in Clo Frull and lie I <br /> CooLl YS U d fo Cw rIe V FIeGt "'L -5' Vc <br /> 7 nfd <br />