Oct 31 2006 13:25 la/al/28e6 13:18 8584146749 DEPR OGA PAGE 83/85 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION. DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, VE, License No, 5908561 PIZZA XTRA RI dent License Type 2010 eEpOn , Case No, 2006048365 ADMINISTRATIVE COMPLAINT : The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Patitioner’), files this Administrative Complaint against PIZZA XTRA, (‘Respondent’), and says: 1. Petitioner is the state agency charged with regulating the eperation 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 4636 W IRLO BRONSON HWY, KISSIMMEE, FLORIDA 34748.The mailing address of record is PIZZA XTRA, at 1633 MARTINSVILLE, ORLANDO, FLORIDA 32825. 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 geverning operation of the establishment, The violation{s) found and applicable law are deseribed in Exhibit"A,” attached hereto and incorporated herein by reference. Inspection decuments 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; 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 to this Chapter, and/or any other relief authorized by Chapter 509, Florida Statutes, or the rules promulgated thereto. Signed September 06, 2006 Valerie Freeman, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants . Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Charles F. Tunnicliff, Lead Attorney Florida Bar No, 0153831 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-1007 CERTIFICATE OF SERVIC BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: | HEREBY CERTIFY that 2 irue and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this. day of , 2006 Received by: Inspector's Signature Operator's Signature ee Ee = Title Title Case Number: 2006043365 District Number: o4 License Number: 5808561 2010 . Form revisad 07.17.06 PIZZA XTRA Oct 31 2006 13:25 1a/31/2686 13:18 8584146749 DEPR OGA PAGE 84/85 Exhibit A License Number: 5908561 . Licanse Type: 2010 PERMANENT FOOD SERVICE Case Number; 2006048365 FC as cited herein references specific provisions of the Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, incorporated by Chapter 610, Florida Administrative Code. NEPA as cited herein references specific provisions of the National Fire Protection Association Life Safety Code, incorporated by reference at Chapter 4A-3, Fire Pravention, Genaral Provisions, Florida Administrative Code, and 61C-1.004(6), Florida Administrative Code. . * denotes a critical violation, It is alleged that on July 3, 2006, August 8, 2006 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 repart(s) for the above referenced inspection(s) are attached hereto and incorporated by reference as Exhibit B. 1. 51-16-1 81G-1.002/6(C)(1) FAC: (1) THE OPERATOR OF EACH PUBLIC FOOD SERVICE ESTABLISHMENT TO BE NEWLY CONSTRUCTED, REMODELED, CONVERTED, OR REOPENED SHALL SUBMIT PROPERLY PREPARED FACILITY PLANS AND SPECIFICATIONS TO THE DIVISION FOR REVIEW AND APPROVAL IN ACCORDANCE WITH THE PROVISIONS OF CHAPTER 508, FS, AMD RULE CHAPTERS 61C-1 AND 61C-4, FAG. SUGH PLANS MUST BE APPROVED BY THE DIVISION PRIOR TO CONSTRUCTION, REMODELING, CONVERSION, SCHEDULING OF AN OPENING INSPECTION AND LICENSING. THE OPERATOR ADDED A HAND DIPPED ICE CREAM FREEZER TO THE FRONT LOBBY AREA OF THE RESTAURANT WITHOUT SUBMITTING PLAN REVIEW. . * 2.97-47-1 5-108.12FC: PRESSURE. WATER UNDER PRESSURE SHALL BE PROVIDED TO ALL FIXTURES, EQUIPMENT, AND NONFOOD EQUIPMENT THAT ARE REQUIRED TO USE WATER EXCEPT THAT WATER SUPPLIED AS SPECIFIED IN PARAGRAPHS 5-104.12(A} AND (B) TO A TEMPORARY FOOD ESTABLISHMENT OR IN RESPONSE TO A TEMPORARY INTERRUPTION OF A WATER SUPPLY NEED NOT BE UNDER PRESSURE. THERE WAS NOC RUNNING WATER AT THE DIPPERWELL FOR THE ICE CREAM FREEZER, * 3,94-08-1 §-204.11 FC: HANDWASHING FACILITY. CONVENIENTLY LOCATED. A HANDWASHING FACILITY SHALL BE LOCATED: (A) TO ALLOW CONVENIENT USE BY EMPLOYEES’ IN FOOD PREPARATION, FOOD DISPENSING, AND WAREWASHING AREAS; AND (B} IN, OR, IMMEDIATELY ADJACENT TO, TOILET ROOMS. THERE WAS NO HAND SINK AVAILABLE NEAR THE ICE CREAM FREEZER. * denotes critical violation Case Number: 2006048365 District: 04 License Number: 5908551 License Type: 2010 PIZZA XTRA

Docket for Case No: 06-004197