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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 ❑ 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 htto7//www accessdata fda gov/scripts/cdrh/cfdocs/cfCFRICFRSearch cfm?CFRPart=150 <br /> Food Descriptions: Gt�C�P ptT e <br /> CV1CCGbke cx))p =bcs np��n pr2 <br /> flxy(�+r cgY-e pqps halkxxnen Cancl_a o:Dchies <br /> Chcmote crake 9�;Ps <br /> s wex oc cies <br /> blcndtes <br /> SC11lJe(dCU dk4e CMUe_S <br /> ChOCdate fU�e <br /> Usmffi <br /> Chocolate CrinlCl� CCx�Y.ies <br /> C ,ce%o bcaunkes <br /> alrnxxl Cco�SS�n� <br /> ehocoate ao zom <br /> eco�sscan� <br /> banana rx� tx�c➢ <br /> ClnnGfYlp�1 CO{�e. 4�Y`1e. <br /> �luebecn� mv�t� <br /> e�cola�e �x�tv�s <br /> czalyneal Cao��eS <br /> 2of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />