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SANJ O A Q U I N Environmental Health Department <br />(7 0U N, TY <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/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Food Descriptions: <br />�AkO PAoKi f, _ grDL0 );C,S SCd F&I3, LUmond bi9c.0 <br />C Q,ltrlAl�' LIYI�� = <br />C)AMO n d I-OKL <br />tYlCtrshm.a.11OUJ tl ilvks sg.wares <br />C,1A0W lU4 CAUQd hJ - 6uskoo <br />Co �(Ot, <br />whom C1aOC.0ukt G76+ <br />S�Or'% Sar �Coc��e� <br />2 of <br />EHD 16-27 6/29/17 CFO REG/PERMITTING FORM <br />