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SA N JO A Q U IN Environmental Health Department <br /> — C0U \ITY--- <br /> Sweet Sorghum Roasted Coffee <br /> Syrup ❑ (Beans/Grounds) ElChocolate 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 amessdata tdl cov/scripts/cdrNddom/cfCFR/CFRSearch cfm?CFRPart=150 <br /> Food Descriptions: p <br /> r aOULk-k, CLIC, 1,_ Glia{--iL�� <br /> Cluj(Giy� �I G Ir ( t"f1�7i(� 1�////✓l ail <br /> C���/i Gllocol�i�{Q-- U�W�II �III__ II'' <br /> CAA a G ��akTTinu+ V /L, <br /> ALI <br /> 2of5 <br /> EHp 16-27 6/29/17 CFO REG/PERMrrnNG FORM <br />