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SAN JOAQUIN <br />(7r 1L1N Y <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 df:scribed in Part,IN pf�11% 21 of the Cone of Federal; <br />Food Descriptions: <br />EHD 16-27 6129/17 <br />avyi h 5. <br />2 of 5 <br />CFO REG/PERMITTING FORM <br />