STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, a lo - [ 0 vs, ITALIAN PASTA & PIZZA EXPRESS License No. 5909632 Respondent, License Type 2010 Permanent Food Service / Case No, 2004045712 ee : ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND 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 609, 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 fecord Is 5180 WIRLO of the provisions of Chapter 509, Florida Statutes, and / or the rules Promulgated therato governing WHEREFORE, Petitioner respectfully requests entry of ari‘ Order imposing one or more of the following penaltles: administrative fine not to exceed $1,000 Per offense; mandatory attendance at Respondent's expense at an educational program sponsored by the Department's Hospitality Education Program; suspension, revocation, or refusal of a license issued pursuant fo this Chapter, and/or any other retief authorized by Chapter 509, Florida Statutes, or the rules promulgated thereto, Signed September 15, 2004 ~ a gous Valerie Freeman, District Manager . By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional! Regulation COUNSEL FOR THE DEPARTMENT: Charlas F, Tunnicliff, Lead Attorney Florida Bar No. 0163831 . Department of Business & Professional Regulation 1840-North Monroe Street Tallahassee, Florida 32399-1007 CERTIFICATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: | HEREBY CERTIFY that a true and correc! Opy of the foregoing ADMINISTRATIVE COMPLAINT has been chant served by me on this PYkday of (be tr brave f 04. ‘ — —_— f rato 20 Received by: a Fen / Lye Ing as Signature Opel § Signature . JO Ltd 4 ; Tila Title Case Number: 2004045712 Form revised 9/8/04 Lloense Type: 2010 Permanent Food Service : District Number: 04 peanoe Number: 5909632 ITALIAN PASTA & PIZZA PRESS License Number: 5909632 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2004045712 Exhibit A “FO" as cited herein references specific provisions of the 1999 Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, incorporated by Chapter 61C, Florida Administrative Code. "NFPA" as cited herein references specific provisions of the National Fire Protection Association Life Safety Code, incorporated by reference at Chapter 4A-3, "Fire Prevention, General Provisions", Florida Administrative Code, and 61C-1.004(5), Florida Administrative Code. It is alleged that on August 2, 2004 and September 9, 2004 the licensee was in violation of Florida Statute 509(FS) and/or the Rules of the Division of Hotels and Restaurants, Florida Administrative Code (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. 1. 14-30 4-501.11FC GOOD REPAIR AND PROPER ADJUSTMENT. (A) EQUIPMENT SHALL BE MAINTAINED IN A STATE OF REPAIR AND CONDITION THAT MEETS THE REQUIREMENTS SPECIFIED IN PARTS 4-1 AND 4-2, (B) EQUIPMENT COMPONENTS SUCH AS DOORS, SEALS, HINGES, FASTENERS, AND KICK PLATES SHALL BE KEPT INTACT, TIGHT, AND ADJUSTED IN ACCORDANCE WITH MANUFACTURERS' SPECIFICATIONS, (C) CUTTING OR PIERCING PARTS OF CAN OPENERS SHALL BE KEPT SHARP TO MINIMIZE THE CREATION OF METAL FRAGMENTS THAT CAN CONTAMINATE FOOD WHEN THE CONTAINER IS OPENED, THE GASKETS ON THE REACH-IN FREEZER WERE IN POOR REPAIR. 2, 22-02 4-601.11(A) FC EQUIPMENT FOOD-CONTACT SURFACES AND UTENSILS SHALL BE CLEAN TO SIGHT AND TOUCH. THERE WAS ENCRUSTED MATERIAL ON THE CAN OPENER. 3. 32-01 61C-1.004(2)(A) FAC & 6-501.18FC BATHROOM FACILITIES SHALL BE KEPT CLEAN, IN GOOD REPAIR AND FREE FROM OBJECTIONABLE ODORS, HANDWASHING LAVATORIES SHALL BE KEPT CLEAN AND MAINTAINED AND USED AS SPECIFIED UNDER SECTION 5-205.11. THE BATHROOM FACILITY WAS NOT CLEAN. * 4.354-01 6-501.111 FC CONTROLLING PESTS. THE PRESENCE OF INSECTS, RODENTS, AND OTHER PESTS SHALL BE CONTROLLED TO MINIMIZE THEIR PRESENCE ON THE PREMISES BY: (A) ROUTINELY INSPECTING INCOMING SHIPMENTS OF FOOD AND SUPPLIES; (B) ROUTINELY INSPECTING THE PREMISES FOR EVIDENCE OF PESTS; (C) USING METHODS, IF PESTS ARE FOUND, SUCH AS TRAPPING DEVICES OR OTHER MEANS OF PEST CONTROL AS SPECIFIED UNDER SECTIONS 7-202.12, 7-206.12, AND 7-206.13; AND (D) ELIMINATING HARBORAGE CONDITIONS. OBSERVED LIVE FLIES WERE IN THE KITCHEN. 5. 36-02 61C-1.004(6) FAC ALL BUILDING STRUCTURAL COMPONENTS, ATTACHMENTS AND FIXTURES SHALL BE KEPT IN GOOD REPAIR, CLEAN AND FREE OF OBSTRUCTIONS. OBSERVED AN ACCUMULATION OF GREASE UNDER THE COOKING EQUIPMENT. “denotes critical violation - Exhibit A Case Number: 2004045712 . Page 1 License Type: 2010 PERMANENT FOOD SERVICE License Number: 5909632 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Division of Hotels and Restaurants CALL BACK/RE-INSPECTION REPORT page {of f_ NOTICE TO SHOW CAUS: You will be issued’a.Notice to Show Cause why sanctions should not be assessed against your license, A hearing will be held at a time and place to be designated by the director. Owner Name: “Potuickd on K Business Name: totic footo- enol tage bp Business Addrass: 5 IFO [U- Benen QLen J Business City: Kaas med WARNING OF DIRECT NOTICE: Failure to bein compliance with this notica at any future inspection may result in a direct Notice to Show Cause, i econ Sonn requested CP re-conference ~(_JNot complied Out of business {_]Pre-hearing (On Stipulation (C0n Hearing Order (Time extended date: CJOther: time: INSPECTOR'S NAME (PLEASE PRINT) ESito Kivevo f? RECIPIENT'S NAME (PLEASE PRINT) "~~ OCe WC £ A JX RECIPJENT'S SIGNATURE FOL. Boliper ESTABLISHMENT TELEPHONE F N O : e Bsa 0500 |, 94 [BBO | BPA 22-005 Revised 5/15/98 8/2/04 4:50:30 PM STATE.OF FLORIDA Page 1 of 8 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS FOOD SERVICE INSPECTION REPORT Inspection Date and Time EXHIBIT B LEGAL NOTICE Failure to comply with this Notice may initiate an administrative complaint that may result In suspenston or revocation of your license and fines. Complaint Full NOS5909632 NOST. Inspection Reason License Number WARNING: BONK PATRICK A Owner Name ITALIAN PASTA And PIZZA EXPRES: 5784 Violations in the operation of your S establishment must be corrected by: Business Name 0 Inspection Result 08/04/2004 08:00 AM Number of Units 5180 W IRLO BRONSON HWY Area Code/Telephone Number 01-APR-05 Callback Date/Time KISSIMMEE FL 34746 License Expiration Address / City / State / Zip / etc. item 03; Faod Temperatures Item 53a: Cert. Food Managers ltem 20: Warewashing Sanitization Item 45: Flre Extinguishers and ression Systems Dates Cheese Mozaralla, Pizza board, 40 Degrees F. Ham, Pizza board, 40 Degrees F. Pepperon|, Pizza board, 40 Degrees F. Chicken wings, hot holding, 140 Degrees F, Q8 99 Certified by: The Florida Restaurant ofnotsetup PPM. Manager Name: Peter Bonk Certification Date: | Sanitizer Type: Chlorine found at concentration Association A Class K type Flre Extinguisher, found Infal Kitchen has a certification date of 07 04 A Class ABC type Fire Extinguisher, faund invat Back door has a certification dale af 07 04 _ — NOTE: Items marked above with an asterisk (*) Indicate a violation Inspector's Comments lo bare hand contact with ready 10 eat food. Go over the big 4 Hepatitis A Salmonelta, Shigella, E coll, mployees must wash their hands TWICE after restroom use,while there Is no hot water in that sink, HOT water Is In all rest of this facilities. © Water jource: Municlpal/Utility, Sewage: Municipal/Utilty. Harry Christianson Employees trained by National Registry of Food Safety Professionals, umberta Martinez Employees trained by National Registry of Food Safely Professionals Provided Web Site: www.hospitalityeducation.org, acknowledge recelpt of this Inspection form and comments. eva oo 08/02/04 6:07 PM Date/Time Signature of Recipient Inspector Signature Recipient: Patrick Bonk For further information please contact: desica Rivera Title Owner Safety Sanitation Specialist 400 West Robinson St. Suite B02 Phone: 407 397 0500 Griando Florida 32801 [_ status SOURCE STATUS PHF TEMPERATURE CONTROL Yes: ‘Ola Approved source re *03b Hot food at proper temperature Yes *01b Wholesome, sound condition Yes *03c Foods properly cooked/reheated Yes 02 Original container; properly labeled, date marking Yes *03d Foods properly cooled STATUS PHF TEMPERATURE CONTROL Yes *04 Facilities to maintain product temperature Yes “03a Cold food at proper temperatures during storage, Rs 05 Thermometers provided and conspicuously placed display, service, transport, and cold halding Yes 06 Potentially hazardous foods properly thawed — Violations marked with an asterisk are critical violations. tems marked YES are in compliance. lems Marked NO are violations. Specific details of violation are listed on subsequent pages. Items marked N/A are Not Applicable. |tems Marked as N/O are Not Observed, and were nat being conducted DBPR FORM HR 5022-014 STATE OF FLORIDA LEGAL NOTICE DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND eee EXHI BIT FOOD SERVICE INSPECTION REPORT Page 2 of 8 License Number BY" NOS5909632 Inspection Date 8/2/04 4:50:30 PM Failure to comply with this Notice may initiate an administrative compiaint that may result in suspension or revocation of your license and fines. Yes Yes 08a Food protection during storage, preparation, display, service, transportation "O8b Cross-contamination, equipment, personnel, storage Yes STATUS *O8c Potential for cross-contamination; storage practices; damaged food segregated (09 Foods handled with minimum contact 10 In use food dispensing utensils properly stored PERSONNEL No Yes STATUS 34 Outside storage area clean, enclosure properly constructed GARBAGE AND REFUSE DISPOSAL 33 Containers covered, adequate number, insect and rodent proof, emptied at proper intervals, clean INSECT AND RODENT CONTROL 35a Presence of insects/rodents. Animals prohibited "35b Outer openings protected from Insects, rodent proof FLOORS, WALLS, CEILINGS 36 Floors properly constructed, clean, drained, coved Yes "44 Personnel with infections restricted No 37 Walls, cellings, and attached equipment, constructed, Yes *12a Hands washed and clean, good hygienic practices clean (observed), altemative operating plan Yes 38 Lighting provided as required, Fixtures shielded Yes *12b Proper hyglenic practices, eating/drinking/smoking Yes 39 Rooms and equipment - vented as required (evidence) 13 Clean clothes, hair restraints OTHER AREAS 40 Employee lockers provided and used, clean FOOD EQUIPMENT AND UTENSILS 14 Food contact surfaces designed, constructed, maintalned, installed, located "41a Toxic Items properly stored *41b Toxic items labeled and used properly 42 Premises maintained, free of litter, unnecessary articles, 15 Non-food contact surfaces designed, constructed, maintained, installed, located 16 Dishwashing facilities designed, constructed, operated 1. Wash 2. Rinse 3, Sanitize Yes 19 Wash, rinse water clean, proper temperature *20a Sanitizing concentration *20b Sanitizing temperature 21 Wiping cloths clean, used properly, stored 22 Food contact surfaces of equipment and utensils clean STATUS 23 Non-food contact surfaces clean Yes 43 Com 144 "45 Fire exting Cleaning and maintenance equipment properly stored. Kitchen restricted to authorized personnel SAFETY lele separation from living/sleep Clean and soiled linen segregated and properly stored uishers - proper and sufficient *46 Exiting system - adequate, good repalr "47 Electrical wiring - adequate, good repair “48 Gas appliances - properly installed, maintained "49 Flammable/combustible materials - properly stored GENERAL 50 Current license properly displayed 24 Storage/handling of clean equipment, ulensils Ni 26 Single service articles not re-used hd WATER AND SEWAGE/PLUMBING *27 Water source safe, hot and cold under pressure Yes [51 Other conditions sanitary and safe operation 0 SINGLE SERVICE ARTICLES Yes 52 False/misleading statements published or advertised 25 Service Items properly stored, handled, dispensed relating to food/beverage es “53a Food management certification valid *53b Employee training validation 54 Florida Clean Indoor Air Act 59 Automatic Gratuity Notice 56 Copy of Chapter 509, Florida Statutes, available GENERAL “28 Sewage and waste water disposed properly Yes 29 Plumbing installed and maintained Na *30 Cross-connection, back siphonage, backflow STATUS TOILET AND HANDWASHING FACILITIES Yes *31 Toilet and handwashing facilities, number, convenient, |Yes designed, installed 32 Restrooms with self-closing doors, fixtures operate properly, facility clean, supplied with handsoap, disposable towels or hand drying devices, tissue, covered waste 57 Hospitality Education Program Information provided 58 Smoke Free Total Number of COS Violations: Total Number of Repeat Violations: 2 i Violations marked with an asterisk are Crilical violations. Items marked YES are in compliance. Items Marked NO are violations. Specific details of violation are listed on subsequent pages. Items marked N/A are Not Applicable. Items Marked as N/O are Not Observed, and were not being conducted Page 3 of 8 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION License Number DIVISION OF HOTELS AND RESTAURANTS NOST = NOS5909632 ingpection Date FOOD SERVICE INSPECTION REPORT EXHIBIT B 8/2/04 4:30:30 PM LEGAL NOTICE Failure to comply with this Notice may initiate an administrative complaint that may result in suspenston or revocation of your license and fines. Warning(s): 14-30 - Observed gaskets in poor repair,at reach in frezzer broken tld. 22-02 - Observed encrusted material on can opener. 23-02 - Observed residue build-up an nonfood-contact surface, In reach In cooler below pizza maker. 27-22 - Observed no hol water provided at hand wash sink, in employee bathroam. 32-14 - Observed tack of handwashing cleanser at handwashing lavatory ,in the kitchen. Corrected On Site. 92-01 - Observed bathroom facility not clean. 32-09 - Observed lack of proper hand drying provisions at hand wash sink. Corrected On Site. 35A-01 ~ Observed live ilies in kiichen,a heavy presence of files all thru the restaurant. 36-03 - Observed grease accumulated under cooking equipment, and all over the kitchen areas,to Include hallways, 37-02 - Observed celling sailed with accumulated waler damage, 47-01 - Observed extension cord In use for non-temporary period. REFERENCE TEXT: 61C-1.004(11) FAC : Electrical wiring — To prevent fire or Injury, defective electrical wiring shall be replaced and wiring shall be kept in good repair. No extension cords shall be used except during cleaning, maintenance and other temporary activities. Only a wall switch or approved pull cord shall be permitted in bathraoms, In accordance with the provisions of NFPA 70, the Natlonal Electrical Code, as adopted by the Diviston of State Fira Marshal in Chapter 44-3, FAC, Uniform Fire Safety Rules and Standards, sufficient electrical outlets shall be provided, 51-04 - Observed no Helmlich maneuver sign posted, 53B-01 - Observed no proof of required employee tralning,for Robert Murphy. 56-01 - Observed copy of Florida Statule 509 not avallable in the establishment. Page 1 of 8 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS FOOD SERVICE INSPECTION REPORT EXHIBIT B LEGAL NOTICE Failure to comply with this Notice may Initiate an administrative complaint that may result in suspension or revocation of your license and fines. 9/9/04 4:52:02 PM Complaint Full NOS5909632 NOST Inspection Date and Time Inspection Reason License Number BONK PATRICK A ANY VIOLATIONS noted herein must be aso Owner Name corrected by the NEXT ROUTINE ITALIAN PASTA And PIZZA EXPRESS INSPECTION, unless otherwise stated. Area Code/Telephone Number Business Name Inspection Result 0 01-APR-05 Number of Units Callback Date/Time License Expiration 5180 WIRLO BRONSON HWY KISSIMMEE FL 34746 Address / City / State / Zip / etc, Item 03; Food Temperatures Item 53a: Cert, Food Managers a Item 20: Warewashing Sanitization | Item 45: Fire Extinguishers and Ham, reach in cooler, 42 Degrees F. *Manager Name: Peler Bonk Certification Dale: | Sanitizer Typa: Chlorine found at concentration | A Class K type Fire Extinguisher, found invat ‘Lazagna, reach In cupler, 42 Degrees F. Q@ 1999 Ceniified by: The Florida Restaurant of nal set up PPM, kitchen has a certification date of 07 04 Association A Class ABC type Fire Extinguisher, found in/at kitchen has @ cerlification date of G7 04 —-———_—____..__... NOTE: Items marked above with an asterisk (*) Indicate a violation Inspectors Comments ‘complaint #2004042695 for bad food and roaches. PIC remembers the complaint and claims the custumer had the wrong location, Mgr Peter Bonk has aken the new MGR Test bul so far there Is no evidence of the results. Observe about 4 dead roaches in hallway by the restroom. Employees tralned by Serve Safe Provided Web Sile: www. hospitalltyeducation.org. y acknowledge receipt of this Inspection form and comments. offs. Ty fone Gi 09/09/04 5:27 PM Signature of Reciplent Inspector Signature Date/Time Recipient: Lori Ann Belottt For further tnformation please contact: Ti Jesica Rivera tle PIC Safety Sanitation Specialist 400 West Robinson St. Suite B02 . Orlando,Florida 32801 Phone: 407397 0500 850 487 1395 SOURCE STATUS PHF TEMPERATURE CONTROL pproved source Yes *O03b Hot food at proper temperature *03c Foods properly cooked/reheated inal container, properly labeled, date marking Yes *03d Foods properly cooled *O1b Wholesome, sound condition Yes 02 Ori PHF TEMPERATURE CONTROL Yes “04 Facilities 10 maintain product temperature *03a Cold food at proper temperatures during storage, Yes 0S Thermometers provided and conspicuously placed display, service, transport, and cold holding Yes 06 Potentially hazardous foods properly thawed Violations marked with an asterisk are critical violations. !tems marked YES are In compliance. ltems Marked NO are violations, Specific details of violation are listed on subsequent pages. items marked N/A are Not Applicable. Items Marked as N/O are Not Observed, and were not being conducied DBPR FORM HR 5022-014 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION —_ License Number DIVISION OF HOTELS AND RESTAURAI H B IT BR NOST Noss909632 s Page 2 of 8 pection Dale FOOD SERVICE INSPECTION REPORT 9/9/04 4:52:02 PM LEGAL NOTICE Failure to comply with this Notica may initiate an administrative complaint that may result in suspension or revocation of your Ilcense and fines. STATUS PHF TEMPERATURE CONTROL STATUS GARBAGE AND REFUSE DISPOSAL Yes 07 Unwrapped or potentially hazardous food not re-served |Yes 33 Contalners covered, adequate number, insect and rodent Yes "08a Food protection during storage, preparation, display, proof, emptied at proper intervals, clean service, transportation Yes 34 Outside storage area clean, enclosure properly Yes *O8b Cross-contamination, equipment, personnel, storage eonstructed Yes "O8c Potential for cross-contamination; storage practices; STATUS INSECT AND RODENT CONTROL damaged food segregated No "35a Presence of Insects/rodents. Animals prohibited Yes OS Foods handled with minimum contact Yes 35b Outer openings protected from insects, rodent proof 10 In use food dispensing utensils properly stored STATUS FLOORS, WALLS, CEILINGS STATUS PERSONNEL Yes 36 Floors properly constructed, clean, drained, coved Yes 41 Personnel with infections restricted Yes 37 Walls, ceilings, and attached equipment, constructed, Yes “2a Hands washed and clean, good hygienic practices elean (observed), allernalive operating plan Yes ——TFtignina provided as required. Fixtures shielded Yes *12b Proper hyglentc practices, eating/drinking/smoking Yes 39 Rooms and equipment - vented as required (evidence) STATUS OTHER AREAS | 13 Clean clothes, hair restraints Yes 40 Employee lockers provided and used, clean STATUS FOOD EQUIPMENT AND UTENSILS Yes "41a Toxic Items properly stored ; Yes 14 Food contact surfaces designed, constructed, *44b Toxic Items labeled and used properly maintatned, installed, located Yes 42 Premises maintained, free of litter, unnecessary articles. Yes 15 Non-food contact surfaces designed, constructed, Cleaning and maintenance equipment properly stored, maintained, installed, located Kitchen restricted to authorized personnel 17 Thermometers, gauges, test kits provided 18 Pre-flushed, scraped, soaked 16 Dishwashing facilities designed, constructed, operated |Yes 1. Wash 2. Rinse 3, Sanitize Yes Yes 19 Wash, rinse water clean, proper temperature Yes “46 Exiting system - adequate, good repair Yes *20a Sanitizing concentration Yes "47 Electrical wiring - adequate, good repair Yes *20b Sanitizing temperature Yes liances - properly installed, maintained 21 Wiping cloths clean, used properly, stored Yes "49 Flammable/combustible materials - properly stared 22 Food contact surfaces of equipment and utensils clean STATUS GENERAL 23 Non-food contact surfaces clean Yes "50 Current license properly displayed 24 Storage/handling of clean equipment, utensils Yes 51 Other conditions sanitary and safe operation STATUS SINGLE SERVICE ARTICLES Yes *52 False/misleading statements published or advertised Yes 25 Service items properly stored, handled, dispensed relating to food/beverage Yes 26 Single service articles not re-used Yes "53a Food management certification valid STATUS WATER AND SEWAGE/PLUMBING. Yes *53b Employee training validation "27 Water source safe, hot and cold under pressure Yes 94 Florida Clean indoor Air Act ‘28 Sewage and waste water disposed properly Yes 55 Automatic Gratuity Notice 29 Plumbing installed and maintained Yes 96 Copy of Chapter 509, Florida Slatutes, available "30 Cross-connection, back siphonage, backflow TOILET AND HANDWASHING FACILITIES GENERAL S87 Hospitality Education Program Information provided *31 Tollet and handwashing factlitles, number, convenient, designed, installed 32 Restrooms with self-closing doors, fixtures operate properly, facility clean, supplied with handsoap, disposable towels or hand drying devices, tissue, covered waste 58 Smoke Free Total Number of COS Violations: ie} Total Number of Repeat Violations: 0 Violations marked with an asterisk are critical violations. Items marked YES are in compliance. Items Marked NO are violations. Specific details of violation are listed on subsequent pages. Items marked N/A are Not Applicable. Items Marked as N/O are Not Observed, and were not being conducted STATE OF FLORIDA Page 3 of B DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION License Number DIVISION OF HOTELS AND RESTAURANTS NOST — NOS5909632 Inspection Date FOOD SERVICE INSPECTION REPORT " EXH | B IT B 9/9/04 4:52:02 PM LEGAL NOTICE Failure to comply with this Notice may Initiate an administrative complaint that may result in suspension or revocation of your IIlcense and fines. Violatian(s): 29-05 - Obsarvad leaking pipe at plumbing fixture, in the restroom. 32-01 - Observed bathroom facility not clean,wih accumulation of black ikea debris,and a heavy bad odar, 354-02 - Observed the accumulation of dead roaches in hallway,

Docket for Case No: 06-001088