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SAN10 A Q U I N Environmental Health Department <br /> --COUNTY <br /> Sweet Sorghum Roasted Coffee <br /> El Syrup (Beans/Grounds) Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> El Donuts and Waffles ❑ Dried Hot Chocolate ❑ Other <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: <br /> I nW vU'es <br /> Mwsk WW I crams <br /> (/_r gIAA Ccid �' �► dlr <br /> tj" A1 Ste„ CG-eesc V �'P <br /> QW,C16 10rre'018 No Yee's <br /> V'2� CYec�s�- <br /> Ckv( CCS cud oY -�'( L i nq <br /> Pvt -M-O-A-t J L a,'2-� <br /> o es CW I' w I+h o wt Kw�s 0_0d- yY i �s <br /> of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />