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SANJ O A Q U I N Environmental Health Department <br /> COUNTY <br /> ❑ Sweet Sorghum ❑ Roasted Coffee [] Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <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 http://www.accessdata.fda.aov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm7CFRP art=150 <br /> Food Descriptions: 9 <br /> r <br /> ov Cat <br /> C <br /> U Cli <br /> 'C C' ki ) f <br /> root!./L v <br /> CSO0 Q_4_-C =. <br /> .Y <br /> 2of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />