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□□□Vegetable and Potato Chips <br />□ □ <br />□Chocolate Covered Nonperishable Food <br />□□□Dried Hot Chocolate Fruit Infused Balsamic Vinegar <br />□Other <br />Food Descriptions: <br />Sample <br />CARROT CAKE WITH WALNUTS <br />Contains: Wheat. Eggs. Walnuts, Pineapple <br />Made in a home kitchen <br />2EHD 16-27 6/29/2023 CFO REG/PERMITTING FORM <br />Ingredience: Fresh Carrots, Certified 100% Organic Unbleached Hard Red Wheat Flour, Enzyme, Granulated White <br />Sugar, Baking Soda, Baking Powder, Salt, Cinnamon, Eggs, Vegetable Oil, Crushed Pineapple with Juice, Vanilla <br />Extract, Walnuts, Raisins <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 Regulations <br />http://www.accessdata.fda.qov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Dried or Dehydrated <br />Vegetables <br />Fried or Baked <br />Donuts and Waffles <br />Dried Vegetarian- <br />Based Soup Mixes <br />Roasted Coffee <br />(Beans/Grounds) <br />Sweet Sorghum <br />Syrup <br />THIS SAMPLE IS GOING TO BE PRINTED ON <br />3 73” x 4” labels <br />Heavenly Choice <br />Lodi, Ca. 95242 <br />San Joaquin County <br />7r fol