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SANJOA 0 U I N Environmental Health Department <br /> ❑ Sweet Sorghum ❑ Roasted Coffee ❑ Chocolate Covered Nonperishable Food <br /> Syrup (BeanslGrounds) <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 het of Ingredients(attach separate page if needed) These items <br /> must comply with standards described 1n Pan 150 of Title 21 of the Code of Federal <br /> Regulations NtofMnvwaccessdata..fda.aov/scrlotslcdrtVcfdmVMFRlCFRSearchcfm?CFRParl=150 <br /> Food Descriptions, <br /> tit' yt,nln ('1�tuc11 _1}���,y, r1k.iPi <br /> �(jl�rr.;�LuLh Lf2���nn+ <br /> 01 5 <br /> EHD 10-77 WV17 CFO RE&VERMITTING FORM <br />