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SA N X10 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 <br /> ❑ 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 http://www.accessdata.fda.gov/scripts/cdrh/cfdoes/dCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> U v—rl u <br /> S. <br /> 2of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />