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SANJ O A Q U I N Environmental Health Department <br /> COUNTY <br /> Dried or Dehydrated Dried Vegetarian- <br /> ❑ Vegetables Based Soup Mixes Vegetable and Potato Chips <br /> Sweet Sorghum❑ Roasted Coffee Syrup El (Beans/Grounds) ElChocolate Covered Nonperishable Food <br /> Fried or Baked <br /> F-1 Donuts and Waffles El Dried Hot Chocolate ❑ Fruit Infused Balsamic Vinegar <br /> Other�c, ter-- .// &—1:1v (< Y,-J<teo &ood-, <br /> Oo 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 ac-cessdata.fda gov/scripts/cdrh/cfdocs/cfCFRICFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> /1-6r G / 00s. f U✓ <br /> �t G'4 uT �i O 04-S — C..tL/6 4 r/ <br /> 2 of <br />