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SA N, J O A Q U I N Environmental Health Department <br /> COUNTY <br /> ❑ Sweet Sorghum ❑ Roasted Coffee Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <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 aov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: /112 � � � SuC'�l gs eJ6o�G/ s C��>�cra � ecC)O L <br /> 2 of 5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />