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SHAWNEnvironmental Health Department <br /> COUNTY— <br /> El <br /> OU NTY— <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup El (Beans/Grounds) ❑ 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://w .accessdata.fda.gov/scripts/cdrh/cfdocs/dCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> DE55CV-S gAI?S ) <OO LtF�, CE/��14L 13 tlZ5, �IcbUE t C-t �ntR, <br /> JAND hREftSS ( F6. MrNANpt 1°JI-MD, PLllMP[UN ISk.OIL <br /> 2of5 <br /> EHD 16-276/29/17 CFO REG/PERMITTING FORM <br />