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SAN 10 A Q U I N Environmental Health Department <br /> --- -COUNTY---- <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup ❑ (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> El Donuts and Waffles ElDried Hot Chocolate ❑ 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.aov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> aGYA r4 , <br /> �a��a�lames ,�� �ti � ��a� -�,�- ��►� �n co.,e.,�;l a..,,d <br /> Tkap(a . <br /> fX&6 ' lar s�-�g� ya�,�f Tod . ('c�c b�, - -, chi l�.k c4; — <br /> 2 of 5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />