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SAN910 A Q U I N Environmental Health Department <br /> —COUNTY— <br /> Sweet <br /> COUNTY— <br /> Sweet Sorghum ❑ Roasted Coffee ❑ Chocolate Covered Nonperishable Food <br /> syrup (Beans/Grounds) <br /> ❑ Fried or Baked ❑ Dried Hot Chocolate <br /> Donuts and Waffles ❑ Other <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:/ANww.ame data.fda.aov/scripts/edrh/dtlococfcFR/CFRSearch ctm?CFRPort=150 <br /> Food Descriptions: <br /> 0 HAV l end S e-di , t U e <br /> �intrrS ( WI1ec1�L� 54 DPI <br /> V i*Aei ail VL I n '. — qAmTfl psesnyetl ez-1d <br /> )Ifily 11-111(!J U n4n fie ev)J <br /> Co e 66 <br /> 2 of5 <br /> FJ-ID 1627 6/79/17 CFO REGa'EFiMnTING FORM <br />