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SANJ O A Q U I N Environmental Health Department <br /> Sweet Sorghum❑ Roasted Coffee El Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <br /> Fried or Baked❑ F] Other <br /> Donuts and Waffles El Dried Hot Chocolate <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/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> Com? .P k es 'Y-6 i G raj 7 (.�3 YtA b.Vier c re ti vvl <br /> M ochit 1 k� Cr4ke v,�AA% wuw9 beuvi Ip as}-e — r-O - 12 — 2 — <br /> 12;c-e L60 k,-e-S "J-e ; batt <br /> C�'SC'-ASS � — <br /> yJ <br /> 2of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />