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Environmental Health Department <br />1. <br />1Commissary Name: <br />Where will the food be prepared? <br />COMMISSARY ON-SITEFOOD ITEM <br />j Sca-llo-P □ <br />I□ <br />2. <br />Equipment <br />Refrigerator <br />cr>\A WfA-'-5 <br />C'OO^ . -Yr <br />2 of 4 <br />Food Production <br />\)<rgp Pftygr <br />~\CkV>\eS <br />I <br />SANJOAOUIN <br />----COUNTY---- <br />KV/ -TfYYTS ’ <br />^ce-pw?- -fefgl <br />^tAnc\ Sheds Qoov, ______ <br />,' Cry^b 4fY^A A\r> <br />•^'or^\^f-VQ Shr GLinr) •'Torr^ <br />Facility ID#: <br />) <br />MENU DESCRIPTION <br />Indicate all the food and beverage items for sale. <br />-V7AMn<A <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 />SudikS <br />Address: C c=r7i <br />"De 1 i mJ VCJhcS <br />H Cl/ i <br />^dclcq _____________________ <br />- PrenuUtn G/rcb SaVciPoUAOj i j