May 1? 2010 13:44 @5/16/2018 88:25 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, VS, MELVIN & ALICE TAKE OUT icons Tye sso Respondent Case Number 2009047342 Administrative Complaint The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Petitioner"), files this Administrative Complaint against MELVIN & ALICE TAKE OUT, ("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 Sectlan 20,165 and Chapter 509, Florida Statutes. 2, Respondent ig, and has been at all times material hereto, licensed by o7 Subject to the jurisdiction af the Division of Hotels and Restaurants. The respondent's business address of record is 4011 NE 205 AVE, WILLISTON, FLORIDA 32696.The mailing address of record is MELVIN & ALIGE TAKE OUT, at 1457 MARGRAETE CRESCENT DR, APOPKA, FLORIDA 32703. 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 therete gaverning 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 43", incorporated herein by reference. WHEREFORE, Petitioner respectfully requests entry of an Order imposing one or more of the fallowing penalties: administrative fine nat 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 Chapter 509, Florida Statutes, or the rules promulgated thereto. Signed September 04, 2009 Steven von Bodungen /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 Certificate of Service BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: 7160 3901 9845 7126 3181 [HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this day of , 2009, ' Raceived by: Inspector's Signature Operator's Signature Title Title Case Number, 2009047342 — File Number: 223752 District Number: 05 Licanse Number: 4800575 2070 Form revised 07.15.09 MELVIN & ALICE TAKE OUT May 1? 2010 13:44 @5/16/2018 88:25 8584146749 DEPR OGA PAGE @4/@5 Exhibit A License Number: 4800575 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2009047342 FC as cited herein references specific provisions of the Food Cade, Recornmendations of the United States Public Health Service, Food and Drug Administration, incorporated by Chapter 61C, Florida Administrative Cade. NFPA as cited herein references specific provisions of the National Fire Protection Association Lif Safety Code, incorporated by reference at Chapter 4A-3, Fire Prevention, General Provisions, Florida Adiministrative Cade, and 61C-1.004(5), Florida Administrative Code. * denotes 4 critical violation. Itis alleged that on May 11, 2009, July 24, 2009 the licensee was in violation of Florida Statute 509(FS) and/or the Rules of the Division of Hotels and Restaurants, Florida Administrative Gode (FAC), in the fallawing particulars, Copy(s} of the report(s) for the above referenced inspection(s) are attached hereto and incorporated by reference as Exhibit B. * 41.5348-07-1 61C-4.023(1) FAG: (1) EACH LICENSED ESTABLISHMENT SHALL HAVE A MINIMUM OF ONE CERTIFIED FOOD PROTECTION MANAGER RESPONSIBLE FOR ALL PERIODS OF OPERATION. OBSERVED NO CERTIFIED FOOD MANAGER FOR ESTABLISHMENT. District: 05 License Type: 2010 File Number: 223752 * denotes critleal violation Case Number: 2009047342 License Number: 4800575 MELVIN & ALICE TAKE OUT

Docket for Case No: 10-002667