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J H K of O AH I it Environmental Health Department <br /> Sweet Sorghum Roasted Coffee <br /> COUNTY— <br /> El Syrup ❑ (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> Fried or Baked Sr <br /> El Donuts and Waffles Dried Hot Chocolate ® Other <br /> MUS i A p S Cz�s <br /> C0N1tr4 ��aS <br /> ' Do not contain eggs,cream, or cream cheese Lu N CY g��� <br /> If preparing jams,jellies or fruit butters,include a list of ingredients(attach separate page if needed). These iterns <br /> must comply with standards described in Part 150 of Title 21 of the Code of Federal <br /> Regulations h :/lv vvw.accessdata.fda. ov/scri ts/cdrh/cfdocs/cfCF CFRSearch.cfm?CFRP rt=150 <br /> Food Descriptions: <br /> L �� 'f I S-0t0 � d <br /> C rn _ s a" Sic C • <br /> C Co 6L 11 4 c,c.+ <br /> n 6,vi, <br /> Q <br /> CtA <br /> 4 <br /> Y <br /> S� <br /> 2of5 <br /> EHD 1rs27 6129/17 CFO REGIPERMITnNG FORM <br />