Department of Alcoholic Beverage Control ON-SALE PREMISES INSPECTION SHEET TYPE OF INSPECTION State of California www.abc.ca.gov IMPACT ROSTF Other DATE AND TIME OF VISIT LICENSEE DBA LICENSE POSTED (Section 24046 B&P) Yes ABC LICENSE NUMBER PREMISES PHONE NUMBER No No N/A CONDITIONS AVAILABLE (Sections 23800 - 23805 B&P) Yes PREMISES ADDRESS MAILING ADDRESS PERSON CONTACTED MANAGER'S NAME DAYS/HOURS OF OPERATION MANAGER HAS BEEN QUALIFIED BY ABC (Rule 57.6 CCR) Yes NUMBER OF EMPLOYEES ON PAYROLL WEAPONS No Unknown Compliance Check DRUG PARAPHERNALIA (Section 11364.7[b] H&S) Notice Given (ABC-546-A) None Observed FOOD SERVICE (Section 23038 B&P) (T-41, 47 and T-75 Only) Violation No Violation N/A GRAFFITI (Section 25612.5[c][6] B&P) (T-40, 42, 48 & 61 Only) Violation No Violation N/A "NO PERSON UNDER 21 ALLOWED" SIGNS (Rule 107 CCR) (T-42, 48 & 61 Only) RETAIL-TO-RETAIL (Section 23402 B&P) Violation No Violation SLOT MACHINES (Section 330[a] PC) Violation No Violation LITTER (Section 25612.5[c][5] B&P) (T-40, 42, 48 & 61 Only) Violation No Violation N/A EXTERIOR LIGHTING (Section 25612.5[c][4] B&P) (T-40, 42, 48 & 61 Only) Violation No Violation OPERATING STANDARDS COPY ON PREMISES (Section 25612.5[c][10] B&P) (T-40, 42, 48 & 61 Only) N/A Violation No Violation "CANCER/PREGNANCY WARNING" SIGNS (Sections 12601[b][1][D][1] and 12601[b][4][E] CCR) N/A Violation No Violation N/A "NO OPEN CONTAINER" SIGNS (Section 25612.5[c][2] B&P) (T-40, 42, 48 & 61 Only) (Violation only if licensee received prior notice from ABC to comply) Posted Not Posted "NO LOITERING" SIGNS (Section 25612.5[c][1] B&P) (T-40, 42, 48 & 61 Only) (Violation only if licensee received prior notice from ABC to comply) Violation No Violation N/A INDOOR SMOKING (Section 6404.5 LC) (Notify DHS of violation) Violation No Violation CONTAMINATED BOTTELS (347 b PC) Violation No Violation SUBJECTS DISCUSSED WITH LICENSEE OR EMPLOYEE Violation No Violation N/A "NOTICE TO CUSTOMERS" SIGNS (Section 25658.4[b]) Violation No Violation HUMAN TRAFFICKING PUBLIC NOTICE (Section 52.6 Civil Code) (T-48 Only) Posted Not Posted RECOMMENDATION: Letter of Warning 24200(e) Letter Other Follow-up I, , received the above information. Signature of Licensee or Agent X ABC AGENT OFFICER/DEPUTY OFFICE AGENCY ABC-531 (rev. 12/2013) 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 OFFICER/INVESTIGATOR DATE Yes No INSPECTION #2 - REPORT OF FINDINGS: ADDITIONAL INSPECTIONS NEEDED OFFICER/INVESTIGATOR DATE Yes No INSPECTION #3 - REPORT OF FINDINGS: OFFICER/INVESTIGATOR RECOMMENDATION: OFFICER/INVESTIGATOR AGENCY DATE ABC-531 (rev. 12/2013) American LegalNet, Inc. www.FormsWorkFlow.com