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SAN OAQUIN <br />_..� _ C 0 U N T Y ---- <br />Sweet Sorghum <br />Syrup <br />❑ Fried or Baked <br />Donuts and Waffles <br />❑ Roasted Coffee <br />(Beans/Grounds) <br />❑ Dried Hot Chocolate <br />Environmental Health Department <br />❑ Chocolate Covered Nonperishable Food <br />FE -1 <br />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 />)J":ntI-Vnr.A.0 hcIrv) —QPCPr V% 10A -dvc�,1I nnD- ookI'PS <br />Ci <br />�l A cheipse -(L�hAOLP 00011,1'e. mJP A' c h rem 4-n poocn- <br />V-T C reo Ci vn toy P.r' I_q r\ t)JV <br />Sa <br />2 of 5 <br />EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />