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SANJ O A Q U I N Environmental Health Department <br /> COUNTY— <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup L1 (Beans/Grounds) Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> Donuts and Waffles ❑ Dried Hot Chocolate LlOther <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.gov/scripts/cdrh/cfdoes/CfCFRICFRSearrch.cfm?CFRPart=150 <br /> Food Descriptions: 04( I,f_S / l�of A 1nl <br /> 2of5 <br /> EHD 16-276129/17 CFO REG/PERMITTING FORM <br />