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SANAAQUIN <br />—COUNTY-- <br />Environmental Hdalth Department ^ k <br />Sweet Sorghum <br />Syrup <br />ri Roasted Coffee <br />(Beans/Grounds) 0 Chocolate Covered Nonperishable Food <br />0 Fried or Baked <br />Donuts and Waffles 0 Dried Hot Chocolate 0 Other <br /> <br />: ....:71 1. IV L.,_.; ,. 1 ..., , .1,_; j .• • : k <br />' Do not contain eggs, cream, or cream cheese . 1 <br />If preparing jams, jellies or fruit butters, include a list of ingredients (attach separate page if needed) These <br />must co,Mplyynihtstandards described in Part 150 of Tit192,1,ofihe Code pf Fcdqval - ,j.. \ .4- , I , „ i ,' ) <br />Regulations hitp-liwww.accessdataida.coviscripts/cdrhicfdocsicfCPR/CFRSeaech.cli-n?CFRPart=150 <br />' <br />Prui 4- Gams, <br />-Ruif - easpberni , Blatberni at-raxolograi Blockbe <br />Pak 0.11 • a rt <br />( <br />items <br />Food Descriptions: <br />other Lyra -jail \\S alsar, penl-co ) Limon <br />duic,e <br />Voni <br />2 of 5 <br />EHD 16-27 6/29/17 CFO REG/PERMITTING FORM