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SANJ O n Q I I I N Environmental Health Department <br /> —COUNTY— <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup El (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> ❑ Donuts and Waffles ❑ Dried Hot Chocolate ElOther <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/Cdrti/cfdocs/CfCFRICFRSewch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> .�ayat l be rs <br /> o laVors 4nri9t✓taJ , mavl9o, e v f-e lue berry r rAW, err,X <br /> e Svie ef <br /> . glrvtilr�.y -b l3row>n�ies� .t�londies <br /> 2of,) <br /> EHD 16-27 6/29/17 CFO REG/PERM MNG FORM <br />