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SAN JOAOUIN <br />OUNTY— <br />❑ Sweet Sorghum <br />Syrup <br />Re Fried or Baked <br />Donuts and Waffles <br />Environmental Health Department <br />/Roasted Coffee chocolate Covered Nonperishable Food <br />/(Beans/Grounds) <br />I� 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 Code of Federal <br />Regulations http://www.accessdata.fda.cov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Food Descriptions: <br />4 Pt 2-2-r-12 <br />v <br />raalied L Choce'164e, Covered ocx+S <br />Imo acorn - cove ced <br />J all, - <br />h;o' C"cackPrs <br />2of5 <br />EHD 16-276129/17 CFO REG/PERMrrrING FORM <br />