State of Florida Department of Business and Professional Regulation Division of Hotels and Restaurants DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, Petitioner, vs. Case Number: - 2014003598 AMBER TIDES LLC License Number: 6215414 License Type: 2002 d/b/a AMBER TIDES LLC, . . Respondent. File Number: 16714 / Administrative Complaint The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Petitioner’), files this Administrative Complaint against AMBER TIDES LLC d/b/e AMBER TIDES LLC, (“Respondent”), and says: 1. Petitioner is the state agency charged with regulating the operation of public lodging establishments and public food service establishments, pursuant to Section 20.165 and Chapter 509, Florida Statutes. : 2. Respondent is, and has been at all times material hereto, licensed by or subject to the jurisdiction of the Division of Hotels and Restaurants. The respondent's business address of record is 420 HAMDEN DR, CLEARWATER BEACH, FLORIDA 33767.The mailing address of record is AMBER TIDES LLC d/b/a AMBER TIDES LLC at 345 HAMDEN DR, CLEARWATER BEACH, FLORIDA 33767. . 3. Inspection of this establishment conducted pursuant to Sec. 509.032, Florida Statutes, revealed violations of the provisions of Chapter 509, Florida Statutes, and / or the rules promulgated thereto governing operation of the establishment. The violation(s) found and applicable law are described in Exhibit “A,” attached hereto and incorporated herein by reference. Inspection documents are attached as Exhibit "B”, incorporated herein by reference. WHEREFORE, Petitioner respectfully requests entry. of an Order imposing one or more of the following penalties: administrative fine-not to exceed $1,000 per offense, suspension, revocation, or refusal of a license issued pursuant to this Chapter, and/or any other relief authorized by Chapiez80S, Florida Statutes, or the rules promulgated thereto. Signed January 28, 2014. V < Danie! Erdman, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business.& Professional Regulation COUNSEL FOR THE DEPARTMENT: Mare Drexler, Lead Attorney Florida Bar No..0487058 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-2202 74e 4008 $l) 4742 4924 Certificate of Service : BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: D | HEREBY CERTIFY that a true.and correct copy of the foregoing ADM MPLAINT has been hand served by me on this day of , 2014. Received by: Inspector's Signature Operator's Signature Title Title Case Number: 2014003598 File Number: 16714 District Number: 03 License Number: 6215414 2002 Form revised 01.01.13 AMBER TIDES LLC Exhibit A License Number: 6215414 License Type: 2002 MOTEL Case Number: 2014003598 It is alleged that on November 07, 2013, January 10, 2014 Respondent was in violation of Florida Statute 509 (FS); the Rules of the Division of Hotels and Restaurants, Florida Administrative Code (FAC); and/or specific provisions of the Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, as incorporated by Chapter 61C, FAC in the following particulars. Copy(s) of the report(s) for the above referenced inspection(s) are attached hereto and incorporated by reference.as Exhibit B. “* denotes a high-priority violation. * denotes an intermediate priority violation. ™ 4. 22-43-4 61C-3.001(3}(a) FAC High Priority: lce making machines shall utilize water from an approved source pursuant to Chapters 62-550 and 62-555, F.A.C., and-shall be constructed, located, installed, operated and maintained so as to prevent contamination of the ice. Observed new ice making machine located outdoors. District Number: 03 Case Number: 2014003598 File Number: 16714 Form revised 01.01.13 License Number: 6215414 2002 AMBER TIDES LLC

Docket for Case No: 14-000729