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l <br /> SANJQ Q Q U IN Environmental Health Deparhnent <br /> --- C OU N T Y----- <br /> El <br /> Sorghum Roasted Coffee <br /> Syrup El (Beans/Grounds) CJ Roasted Covered Nonperishable Food <br /> Fried or Baked <br /> ❑ Donuts and Waffles ❑ Dried Hot Chocolate ❑ 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 Cade of Federal <br /> Regulations http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: r <br /> i <br /> - 2of5 <br /> EHD 16-27 6129117 - CFO REGIPERMITTING FORM <br />