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An <br />SA N sJ O A Q I I 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 />ANU-C chprplclk rh ip �oow es <br />qV "c'doo- l -e COW <br />A'linu-� W+W rout P'� <br />yhte chcalake ma(l1tmib cobs <br />coulgAr <br />oafiw. <br />al coowils <br />D1roWNL�� <br />cu�oc�c�e s <br />2 of <br />EHD 16-27 6/29/17 CFO REG/PERMnTING FORM <br />