Arillis Corp in Felda

Comments: Offsite Check-Back release issued for Stop Sale Order. Updated label for flour tortillas provided to inspector included known allergen, wheat, and sub-ingredients. ACKNOWLEDGMENT I acknowledge receipt of a copy of this document, and I further acknowledge that I have verified the location and mailing addresses on the first page of this document are correct, or I have written the correct information on the first page of this document. (Signature of FDACS Representative) BRITTANY SMITH, ENVIRONMENTAL SPECIALIST II (Signature of Representative) ALEX MENDEZ, MANAGER Print Name and Title FDACS 14205 Rev. 07/13 Page 1 of 1 Florida Department of Agriculture and Consumer Services Division of Food Safety Bureau of Food Inspection Attention: Business Center 3125 Conner Boulevard, C-26 Tallahassee, FL 32399-1650 FOOD SAFETY INSPECTION SUPPLEMENTAL REPORT Florida Statues. Chapter 500.172, 500.174 (850) 245-5520 NICOLE "NIKKI" FRIED COMMISSIONER Food Entity #: Food Entity Name: Date Of Visit: Food Entity Location Address: Food Entity Mailing Address: Food Entity Type/Description: Food Entity Owner: *99997182183801*

Comments: A copy of the RFR AT A GLANCE guidance document was provided. You are required to submit the registration within 24 hours for the products containing know allergens ( wheat) that were distributed into commerce without a full ingredient list for all products within your established shelf life. The following hand outs distributed to food establishment management: FDA Firm QR Resources, RFR at a glance, Allergen Awareness, Food Labeling Guide, Food Facility Registration. Payments can be made online at https://foodpermit.fdacs.gov or can be mailed to Florida Department of Agriculture and Consumer Services, P.O. Box 6720, Tallahassee FL 32314-6720. Checks and money orders are to be payable to Florida Department of Agriculture and Consumer Services. All payments must include the Food Establishment number and reason of payment type in the memo section of the check or money order. Re-inspection visit required issued for food establishment. A re-inspection will be conducted on or about 14 days. Thank you for submitting your food establishment permit application. To complete the application process, you must remit payment in full. To expedite the processing of your food permit application, electronic online payment is available at https://foodpermit.fdacs.gov. Follow the instructions on the portal page for payment processing. Payment by check or money order is also accepted, but must be made payable to FDACS and remitted to Florida Department of Agriculture and Consumer Services, PO Box 6720, Tallahassee, FL 32314-6720. Please note that payment by check or money order may delay the processing of your food permit application. Permit fees must be paid in full before your application can be processed further. Failure to pay any permit fees in full will result in the denial of your permit and you may be subject to administrative penalties if you are found operating without a valid food permit, which is a violation of Section 500.12(1)(a), Florida Statutes. If you are found to be in violation of this provision, the Department may impose up to a $5,000.00 fine against you and/or seek administrative action to close your business. The Minimum Construction Standards checklist has been used in accordance with 500.12(2)(a) Florida Statutes by the food safety inspector to determine compliance before obtaining a food permit. FDACS 14205 Rev. 07/13 Page 4 of 5 Florida Department of Agriculture and Consumer Services Division of Food Safety FOOD SAFETY INSPECTION REPORT NICOLE "NIKKI" FRIED COMMISSIONER Chapter 500, Florida Statutes (850) 245-5520 *99997182183729* Visit # 9999-7182-1837-29 Bureau of Food Inspection Attention: Business Center 3125 Conner Boulevard, C-26 Tallahassee, FL 32399-1650