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SA KJ 0 A QU I N Environmental Health Department <br /> -COUNTY <br /> Sweet Sorghum❑ Roasted Coffee Syrup 1:1 (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> El Donuts and Waffles ❑ Dried Hot Chocolate F-1Other <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 htti)://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> OVA �Cwt Y\(A _ <br /> Wi4I(A ih <br /> f � Gly Ww-i -A 0t��t�`1�C cha" V- 'K <br /> uj ' <br /> MA CA 001 4�IUA <br /> 2 of 5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />