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Sf) N O A Q U I N Environmental Health Department <br /> —NiCOUiNITY— <br /> ❑ Sweet Sorghum Ix 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 /> It preparing jams.Jellies or fndt butters,include a list of ingredients(attach separate page if needed). These items <br /> must comply with standards described in Pan 15O of Idle 21 of the Code of Federal <br /> Regulations IxAmor.noessdata,fda.00v/striata/cdrh/efdoW—dCFR/CFR$earch.dm?CFRPart=750 <br /> Food Descriptions: WG bv� II Otrt Cr (OtfCG�bf.�+LS �Y�d ✓02-tr <br /> . itCYC/►� }G r'W If rYyy'N b6 i ►v' Iif�T,T�Jr. <br /> 2 5 <br /> EHO 1627 Gr2M7 CFO REGMERWMNG FORM <br />