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SAN JOAQUIN <br /> Environmental Health Department <br />COUNTY-- <br />Food Production <br />1. Indicate the location where you will store food and equipment at the end of the day. <br />Commissary Name: \)1 ,c:13Rv. Facility ID #: <br />Address: t4\0i-r-i N6t-',1) C-1S\ C V.3;0:5 <br />WHERE WILL THE FOOD BE PREPARED? <br />MENU DESCRIPTION <br />Indicate all the food and beverage items for sale. <br />ON-SITE COMMISSARY <br />FOOD ITEM <br />,3\„.1 Lot-K. <br />E <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 <br />1121(s- CAt9t ia`Ce'lle` IA/Mk-VAN Colt. ItoWeilt..-Nii4.-vz) y,0.2 ‘C-C- 6L.AS c7R0Z-E:Ni <br />S140\1104) 1,4)0,LL. )iv-tkIk'. eiv\me..i %GE. atpois <br />C.:11iAtta- $.,C) lz, F074 De.itfkED CDt-iE (..' \A kir. f:R 5140‘4 (,.).4c.. <br />rtkVitsitiJ ‘2:00TTLE Ise.p -Tb otsPe.t4sE VW oril-0 c_Akt.,\JED itx_ <br />ra A