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r. <br /> SAN JOAQUIN <br /> Environmental Health Department <br /> COUNTY <br /> ❑ Sweet Sorghum ❑ Roasted Coffee Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <br /> Fried or Baked F] 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 hftp://www accessdata fda goy/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> PGS- rvx� _ Cao k.1-e S G,�'Sy l ray=z S <br /> r <br /> 2of5 <br /> EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />