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SA N J Q 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 /> Donuts and Waffles ❑ Dried 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 htt�//w w accessdata fda gov/scdPts/cdrh/cfdog cfCFR/CFRSearch cfm?CFRPart—1 50 <br /> Food Descriptions: <br /> EHD 16-27 6/29/17 2 of 5 <br /> CFO REGMERMIrTING FORM <br />