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SAN10 A Q U I N Environmental Health Department <br /> - COUNTY <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> ❑ Donuts and Waffles E] Dried Hot Chornlata r-1Other <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 hno:iiwww.amessdam-fdaaoviscriorsicdrhicfdocsicfcFkiCFRSearch.cim%CFRParr-i 5u <br /> Food Descriptions: <br /> -ADSfi' i <br /> a W 2 . <br /> �ao.�n C.i� rvmoueS ��` �j2 Yl1oi (C '�i'om 't <11�Y1dU i <br /> nT�CVNA Q.YYI fyr o. `nnrziQro.QT()A oft% - <br /> `�.re �a s ca1c�� >n�rttln�rn� �a�ye S��r2 Same <br /> 2 of <br /> EHf716-775/29117 CFO REGIPERMITTING FORM <br />