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Dried or Dehydrated <br />Vegetables <br />Sweet Sorghum <br />Syrup <br />Fried or Baked <br />Donuts and Waffles <br />LI Vegetable and Potato Chips <br />LI Chocolate Covered Nonperishable Food <br />Dried Hot Chocolate LII Fruit Infused Balsamic Vinegar <br />Dried Vegetarian- <br />Based Soup Mixes <br />Roasted Coffee <br />(Beans/Grounds) <br />LI Other <br />* Do not contain eggs, a-earn, 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 Regulations <br />http://www.accessdata.fda.goy/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Food Descriptions: <br />d--Ec-0141 ouurd, h brea6L <br />Rk_ryi AOR ovi <br />&)LAfd Ok Gratwis k4J Oil lie, a I 4.kr <br />CyO1/rVL break (A0-11() Wall() tti-6 <br />'La 1 /410(eak (A)(4-14) 1,0a_Pii u t5 <br />lAcr(- jhrn finjironi fifftl,P uI5 ne,5 4 jur, wet_t_fl <br />Powettra 1Dbo-f)1Appit 19&17 V&4uJt4,L1U, 6,14/D44y1rou . <br /> <br />P+-e--b.teL-K-, i.t,1 - Se.ed, )0t,tird,04.4.) breccol <br />Gailtc> FaDeniodj &ctrctoGt6aumorjd <br />aoccrd 5Mk-, z-zck- do cl• ?C'v rowed .p11,9A, 144,144' ‘ie 6VArri4 A- <br />o1k rct o tkLik 813e.16 z(tsi <br /> <br />CBanct.f)(, brea(I. <br />u_rolou# Garl to 66ty 13 <br />3oci c*L_Irh 1/±j2?) lad- ht bAje- ez) je-b <br />c.5)torciArtok., 0i1150 <br />END 16-27 6/29/2023 2 CFO REG/PERMITTING FORM