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SAN<J O A Q U I I\ Environmental Health Department <br /> COUNTY <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup E] (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> El Donuts and WafflesElDried 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.gov/scripts/cdrh/Gfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> A yy\o r.- `40 C A-- <br /> Qc9 Cry <br /> ��►�a�5 C.�n ►2vc� &aL <br /> cl tS woZ)'ggelee'spuowly'wnod Z/l <br /> befi%5 e 'gllw pesuepuoD 1�[(.6�S6L' WP' �,r <br /> peueleems 1tiesesra V✓w 9,�2 NN1e <br /> pezpnlsedpepng •IelllueA ✓ <br /> wind u!W1eeleAos9onb0 8tz(o,3o4D>hQa <br /> 'elel0004o bepnq e0000 Apr,y�pR 1e415310000 <br /> beans)alel000gp:sluelpwBul i0'IROM <br /> L99z•6Z9(60z) <br /> woo selcillslseu!wwwoauue dz`s 1.'6L <br /> we]'selgll918ew I8awlevm <br /> LLCCZ0D# Aunoo <br /> ulnbeor ueS b0Cg6'V3'Pw1 <br /> peoH es1P-8d WV8 L <br /> uegollN ewoH P801NB0 <br /> 8 ul WISJOS woy epey9 <br /> A>�.TL,7 LL ria Made from Scratch in a <br /> •Y+V'�V?YP) caroled Home Kitchen <br /> Bazl (+z�Tt]T(1 18461 Paradise Road <br /> �Dl`OihO Olsflt® Tracy,CA.95304 San <br /> 6601XES MWCA yam WORLDI Joaquin County <br /> ANNA'S ROCK'N #0023311 <br /> ROLA ROAD www.ennaalmaeletlblea.eom <br /> annadilia....I"SistlblMoare <br /> Fudge Loyertopped will,whole (209)629.2851 <br /> Toaskd Almmlds.Anna's Roca ingredients:Budw.Sugar, <br /> and Homemade Marshmallows Almonds,Chocolate <br /> Hand Dlpp.d in D.rh Chomkts (sugar,cocoa butter <br /> 4....(123989) chocolate,liquor,soya <br /> lecithin,pure vanilla) <br /> 2 of <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />