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SANJ O n Q I ( I N Environmental Health Department <br /> --CO U NT <br /> Y------- <br /> ❑ Sweet Sorghum ❑ Roasted Coffee ❑ Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <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: <br /> ft?veL w <br /> ezAn/J � 4 /aW- e <br /> GZ I C d s " <br /> FOX FARM — - -- <br /> 2of5 <br /> EHD 16-27 6/29/17 CFO REGIPERMITTING FORM <br />