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—c M N 0 Mn U IN <br /> Environmental Health Department <br /> COUNTY— <br /> ED <br /> Sweet Sorghum ❑ Roasted Coffee ElChocolate 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 htto://www.accessdata.fda.00v/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> Manop ,Sero - p aUchm _ co hua <br /> 2 of <br /> EHD 16-27 6129/17 CFO REG/PERMITTING FORM <br />