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SA N-J O A Q U IN Environmental Health Department <br /> COUNTY <br /> ❑ Sweet Sorghum ❑ Roasted Coffee ❑ Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <br /> Fried or Baked <br /> El Donuts and Waffles ElDried 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/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> z.�c r-e a <br /> rl"�t C c' <br /> L"k', <br /> C"LA(u�- dk,� a,,Lr<lc e-s <br /> 2of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />