Download - Shannon’s Imperial Brandshannonsimperial.com/pdf/SB-210 51% Whole Wheat Aloha...2019/05/09 · SB-210 51% Whole Wheat Aloha Dinner Roll Packed 8/24 = 192 / 1oz I certify that each

Shannon’sImperialBrand7080N.WhitneyAve.,#103Fresno,CA93720Phone:925-223-8171Fax:559-324-8477Email:[email protected]:www.shannonsimperial.com

May9,2019

SB-21051%WholeWheatAlohaDinnerRollPacked8/24=192/1ozIcertifythateachShannon’s51%WholeWheatAlohaDinnerRollcontainsnolessthan16gramsofcreditablegrainswithnolessthan8gramsofwholegrainflour,whichequalsonegrainserving.16grams/8grams=1e.g.

LynnJensenOfficeManager

IngredientStatementWater,WholeWheatFlour,EnrichedFlour(WheatFlour,MaltedBarleyFlour,Niacin,FerrousSulfate,ThiaminMononitrate,Riboflavin,FolicAcid),Sugar,Yeast,Contains2%orlessof:SoybeanOil,VitalWheatGluten,Salt,CalciumSulfate,CalciumPropionate(Preservative),YellowCornFlour,MonoDiglycerides,NaturalandArtificialFlavors,EnzymesandAscorbicAcid(DoughConditioners),ColorAdded.

Contains:WheatandSoy.

FormulationStatementforDocumentingGrainsinSchoolMeals(CreditingStandardsBasedonGramsofCreditableGrains)

SchoolFoodAuthorities(SFAs)shouldincludeacopyofthelabelfromthepurchasedproductpackageinadditiontothefollowinginformationontheletterheadsignedbyanofficialcompanyrepresentative.SFAshavetheoptiontochoosethecreditingmethodthatbestfitsthespecificneedsofthemenuplanner.ProductName:51%WholeWheatAlohaDinnerRoll CodeNo.:SB-210Manufacturer:Shannon'sImperialBrand ServingSize:__28.3grams_1oz.

I. DoestheproductmeettheWholeGrains-RichCriteria:Yes__X__No____

II. Doestheproductcontainnon-creditablegrains:Yes____No_X__Howmanygrams:_____

III. UsePolicyMemorandumSP30-2012GrainRequirementsfortheNationalSchoolLunchProgramandSchoolBreakfastProgram:ExhibitAtodetermineiftheproductfitsintoGroupsQ-G(bakedgoods),GroupH(cerealgrains)orGroupI(RTEbreakfastcereals).(Differentmethodologiesareappliedtocalculateservingsofgraincomponentbasedoncreditablegrains.GroupsA-Gusethestandardsof16gramscreditablegrainperozeq;GroupHusesthestandardor28gramscreditablegrainperozeq;andGroupIisreportedbyvolumeorweight.)

IndicatetowhichExhibitAGroup(A-I)theProductBelongs:___B_____

DescriptionofCreditableGrainIngredient

GramsofCreditableGrainIngredientper

PortionA

GramStandardofcreditableGrainperoz

equivalent(16gor28g)BCreditableAmountA/B

WholeWheatFlour 8.52grams 16grams/ozEqgrain .531EqGrainEnrichedFlour 8.19grams 16grams/ozEqgrain .512EqGrain

16.71

1.04

TotalCreditableAmount 1EqGrain

TotalWeight(perportion)ofproductaspurchased___28.3grams___Totalcontributionofproduct(perportion)__1__ozequivalentIcertifythattheaboveinformationistrueandcorrectandthata28.3gramportionofthisproduct(readyforserving)provided1equivalentGrains.Ifurthercertifythatnon-creditablegrainsarenotabove0.25ozeq.perportion.Productswithmorethan0.24ozequivalentor3.99gramsforGroupsA-Gor6.99gramsforGroupHofnon-creditablegrainsmaynotcredittowardsthegrainrequirementsforschoolmeals.

OfficeManager Signature Title

LynnJensen5/9/2019925-223-8171,ext.108PrintedName Date PhoneNumber