Department of Alcoholic Beverage Control OFF - SALE PREMISES INSPECTION SHEET State of California www.abc.ca.gov TYPE OF INSPECTION IMPACT ROSTF Other DATE AND TIME OF VISIT DBA LICENSEE LICENSE POSTED (Section 24046 B&P) Yes No ABC LICENSE NUMBER PREMISES PHONE NUMBER CONDITIONS AVAILABLE (Sections 23800 - 23805 B& P) Yes No N/A PREMISES ADDRESS MAILING ADDRESS PERSON CONTACTED DAYS/HOURS OF OPERATION WEAPONS NUMBER OF EMPLOYEES ON PAYROLL Compliance Check BEER KEG REGISTRATION (Section 25659.5 B&P) Violation No Violation N/A RETAIL - TO - RETAIL (Section 23402 B&P) Violation No Violation CLERK AFFIDAVITS (Section 25658.4[a] B&P) Violation No Violation GRAFFITI (Section 25612.5[c][6] B&P) Violation No Violation CONCURRENT SALES GAS/ALCOHOL (Section 23790.5 B&P) Violation No Violation N/A LITTER (Section 25612.5[c][5] B&P) Violation No Violation DRUG PARAPHERNALIA (Section 11364.7[b] H&S) Notice Given (ABC - 546 - A) No ne Obs erved (Section 25658.4[b] B&P) Violation No Violation EXTERIOR LIGHTING (Section 25612.5[c][4] B&P) Violation No Violation EXCESSIVE SIGNS (Section 25612.5[ c][7] B&P) Violation No Violation HARMFUL MATTER (Section s 313.1 PC and 25612.5[c][9] B&P ) Violation No Violation N/A TOBACCO WARNING SIGN (Section 22952 B&P) Posted Not Poste d (DHS to be notified) OPERATING STANDARDS COPY ON PREMISES (Section 25612.5[c][ 10] B&P) Violation No Violation (Section 25612.5[c][2] B&P) (Viol ation only if licensee received prior notice from ABC to comply) Violation No Violation N/A (Section 25612.5[c][1] B&P) (Violation only if licensee received prior notice from ABC to comply) Violation No Violation N/A (Sections 12601[b][1][D][1] and 12601[b][4][E] CCR) Posted Not Posted T ELEPHONE: NO INCOMING CALLS (Section 25612.5[c][8] B&P) (Violation only if licensee received prior notice from PD/SO to comply) Violation No Violation N/A SUBJECTS DISCUSSED WITH LICENS EE OR EMPLOYEE RECOMMENDATION: Letter of Warning 24200(e) Letter Other Follow - up I, , received the above inform ation. Sig nature of Licensee or Agent ABC AGENT OFFICER /DEPUTY OFFICE AGENCY ABC-537 (rev. 0/1) White - ABC Canary - Police/Sheriff's Department Pink Licensee American LegalNet, Inc. www.FormsWorkFlow.com Follow - up Inspection INSPECTION #1 - REPORT OF FINDINGS: ADDITIONAL INSPECTIONS NEEDED Yes No OFFICER/ DEPUTY/AGENT DATE INSPECTION #2 - REPORT OF FINDINGS: ADDITI ONAL INSPECTIONS NEEDED Yes No OFFICER/ DEPUTY/AGENT DATE INSPECTION #3 - REPORT OF FINDINGS: OFFICER/ DEPUTY/AGENT RECOMMENDATION: OFFICER/ DEPUTY/AGENT AGENCY DATE ABC-537 (rev. 0/1) American LegalNet, Inc. www.FormsWorkFlow.com