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SA N J O A.OU 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 http'//www accessdata fda aov/scripts/cdrh/cfdocs/cfCFR/CFRSearch cfm?CFRPart=150 <br /> Food Descriptions: <br /> -eArs cLsz 0� d �e-ssg- @y71At 6 PEifs CV-LJ -z' <br /> 1,7 I Tv` CA La.9-e,�-e v � e/Y%Ak6 , '�a> 2-6 .l f ✓nL _� N <br /> T`t <br /> CQ cz <br /> 2of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />