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SHAWNA N�AID O/� �1I I I � Environmental Health Department <br /> —CVOUNHTIrYV <br /> ❑ Sweet SorghumEl (Beans/Grounds)Roasted Coffee <br /> Syrup ❑ Chocolate Covered Nonperishable Food <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/odrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> PiN 00"A (FITINO WK ) <br /> COW TW <br /> bUk PIG ( g0U0 WOW Pit) <br /> Ocl PIS 0%TM PIC) <br /> 2 of <br /> EHD 16-27 6/29/17 CFO REWERMITTING FORM <br />