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SANJ O A Q U I N Environmental Health Department <br /> COUNTY <br /> Sweet Sorghum Roasted Coffee <br /> E] SyrupEl (Beans/Grounds) Chocolate Covered Nonperishable Food <br /> ❑ Fried or Baked d 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: /ttzI e <br /> f ji al e'll 1 de% <br /> hak�wld ,`' ✓ y)' <br /> 2of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />