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SANJ O A Q U I N Environmental Health Department <br /> Sweet Sorghum Roasted Coffee <br /> F-1 Syrup ❑ (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> ❑ Fried or Baked ❑ Dried Hot Chocolate ❑ Other <br /> Donuts and Waffles <br /> * Do not contain eggs, cream, or cream cheese <br /> **If preparing jams,jellies or fruit butters, include a list of ingredients(attach separate page if needed). These items <br /> must comply with standards described in Part 150 of Title 21 of the Code of Federal <br /> Regulations http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: 1 V mS Such m <br /> c GV.QS mrd P ins.CA Sb OCCOG 0,I C 6 5 re <br /> I�.-rheu In,ilj CaUerca ,'r; bejftfr—r'rulh rrosfinga G (J <br /> SCVW_: ;,rr,C s JOY)(�O,fjk ftAA e <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />