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SANJ O A Q U IN Environmental Health Department <br /> —COUNTY— <br /> ❑ Sweet Sorghum ❑ Roasted Coffee ❑ Chocolate Covered Nonperishable Food <br /> Syrup (Beans/Grounds) <br /> Fried or Baked <br /> El Donuts and WafflesL] Dried Hot Chocolate ❑ Other <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/cdrh/cfdocs/cfCFR/CFRSearch cf n PCFRPart=150 <br /> Food Descriptions: <br /> gJe - <br /> C-jir.c� S C�1lp S <br /> 2 of <br /> EHD 1&278/29/17 CFO REG/PERMrTTING FORM <br />