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SANAOAQUIN <br />-COUNTY- <br />Environmental Health Department <br />❑ Sweet Sorghum ❑ Roasted Coffee Chocolate Covered Nonperishable Food <br />Syrup (Beans/Grounds) <br />EJ Donuts <br />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 htt ://www.accessdata.fda. ov/scd is/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Food Descriptions: C`cky-e,j, <br />M . _ _ c r.n <br />%w-' pdPS <br />1-bt Ceco• 6, <br />-%,n,A5 Ch <br />I I f yP'J� <br />3 <br />2 of <br />EHO 16-27 6/29!17 CFO REG/PERMITTING FORM <br />