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SAN JOAQUIN <br />COUNTY <br />Environmental Health Department <br />❑ Sweet Sorghum ❑ Roasted Coffee ❑ Chocolate Covered Nonperishable Food <br />Syrup (Beans/Grounds) <br />❑ Fried 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:/Iwww.accessdata.fda. ov/scri ts/cdrh/cfdoes/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Food Descriptions: <br />flI1L(ii►1flIFAIIIIIIIIII.9//ill4L: i/ iSII%71�,:J1:L>/!�'lill►=LJL/�7J/!J <br />GIIngw &1rGK,¢rr adle er2liGe, <br />2 of 5 <br />EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />