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SANJ O A Q U I N Environmental Health Department <br /> COUNTY <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup (Beans/Grounds) Chocolate Covered Nonperishable Food <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 described in Part 150 of Title 21 of the Code of Federal <br /> Regulations http://www.accessdata.fda.aov/scripts/edrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> ba'w 0001i eA <br /> L? 0g,6\, s1 12a s, n <br /> C$oLolave Nityo <br /> U ��csrl-�reo� <br /> Pn oOQM_ Coca Lr c� in 0+0 c.0 ia4e a- C- ra and <br /> 1 hookav-t Ort.4%x1s. <br /> Li t� CCS" <br /> v <br /> 2 of 5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />