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SA <br /> NJ O A O I I IN <br /> Environmental Health Department <br /> COUNTY— <br /> Sweet Sorghum ❑ Roasted Coffee ❑ Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <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.fda.gov/scril)tstcdrhtcldoc tcfCFR/CFRSearch cfm'+CFR Pan=150 <br /> Food Descriptions: <br /> —C Ok�PS nar ire ICZ R'5�ti14' !2* <br /> C .� /7 VL10 GG1 <br /> �C o"J ' C/A/(ICG lL IP , Aa,T, 0ny� K.tNAi( <br /> P(ti'V <br /> i <br /> i <br /> I <br /> 2of5 <br /> EMD 1&276/29/17 CFO REG/PERM117ING FORM <br />