Inspector: GUISELLA URIBE, ENVIRONMENTAL SPECIALIST II
Risk-Based Violations
Retail Area: Unable to verify source for hemp extract products intended for ingestion
including gummies and food products. Stop-sale order issued. See supplements.
Retail Area: Unable to verify source for hemp extract products intended for inhalation
including pre rolls. Stop-sale order issued. See supplements. Retail Area: Unable to verify source for hemp
extract products intended for inhalation for Rave Budz brand Gas Pack line of products. COS, invoices
were provided for these products during inspection.
Retail Area: Hemp extract products including pre rolls found without the statement "Not
Intended For Ingestion - Do Not Eat" on product packaging. Stop-sale order issued. See supplements.
Retail Area: Hemp extract products, including Rave Budz brand Gas Pack line of products found without the
statement "Not Intended for Ingestion - Do Not Eat" on product packaging. COS, products were properly
labeled during inspection.
o
Retail Area: Hemp extract products including pre rolls found without a scannable
barcode/quick response code, a batch number, an expiration date, an internet address, and/or the number
of milligrams of each marketed cannabinoid on product packaging. Stop-sale order issued. See
supplements.
o
Print Date: 8/2/2024
Page 1 of 3
75
Citation Description: Hemp extract intended for human consumption distributed or sold in the state not
labeled pursuant to s. 500 F.S., s. 581.217(7) F.S., 5K-4.034(6)(a), F.A.C.
Observation: Retail Area: Hemp extract products including pre rolls found without manufacturer's
information and/or net weight identified on product packaging. Stop-sale order issued. See supplements.
o
Retail Area: Hemp extract products including pre rolls found without serving size identified on
product packaging. Stop-sale order issued. See supplements.
o
Retail Area: Hemp extract products including food products and prerolls do not have a
corresponding certificate of analysis by an independent testing laboratory. Stop-sale order issued. See
supplements. Retail Area: Hemp extract products including Rave Budz brand Gas Pack line of products do
not have a corresponding certificate of analysis by an independent testing laboratory. COS, a certificate of
analysis were provided for each product during inspection.
Retail Area: Hemp Extract products observed to be Attractive to Children - product and/or
labels in the shape of an animal, human, or cartoon; or bears any resemblance to an existing candy
product. Stop-sale order issued. See supplements.
o
Retail Area: no invoice or manufacturer information available for multiple Rave Budz
products and they could not be determined to come from an approved source. Stop-sale order issued. See
supplements.
o
Retail Area: multiple packages of Rave Budz products were found without source
information, net weight, and/or ingredients on product packaging.
Good Retail Practice Violations
No three compartment sink with hot and cold running water and proper drainage available for
employees to use to wash, rinse, and sanitize food equipment as required. Stop-use order issued. See
supplements.
Retail Area: multiple packages of Rave Budz products found to contain muscimol,
muscarine, ibotenic acid, and/or amanita muscaria. Stop-sale order issued. See supplements.
o
A Supplemental Report was also issued during the visit which includes important information for management.
Stop-Sale Orders & Supplemental Actions
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 1 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 2 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 3 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 4 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS
581.217 Distribution and Retail Sale of Hemp Extract. * Attractive to Children.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 5 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Chapter 5K-4: Food deemed adulterated.
Comments: The product contains a poisonous or deleterious substance and may not be sold or distributed. To request a Food Safety Inspector
visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product, contact the Business Center at (850)
245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Chapter 5K-4: Food deemed adulterated.
Comments: The product contains a poisonous or deleterious substance and may not be sold or distributed. To request a Food Safety Inspector
visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product, contact the Business Center at (850)
245-5520 or
[email protected].
Print Date: 8/2/2024
Page 6 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Chapter 5K-4: Food deemed adulterated.
Comments: The product contains a poisonous or deleterious substance and may not be sold or distributed. To request a Food Safety Inspector
visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product, contact the Business Center at (850)
245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source: Food obtained from approved source.
Comments: The product contains a poisonous or deleterious substance and may not be sold or distributed. To request a Food Safety Inspector
visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product, contact the Business Center at (850)
245-5520 or
[email protected].
Print Date: 8/2/2024
Page 7 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source: Food obtained from approved source.
Comments: The product contains a poisonous or deleterious substance and may not be sold or distributed. To request a Food Safety Inspector
visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product, contact the Business Center at (850)
245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source: Food obtained from approved source.
Comments: The product contains a poisonous or deleterious substance and may not be sold or distributed. To request a Food Safety Inspector
visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product, contact the Business Center at (850)
245-5520 or
[email protected].
Print Date: 8/2/2024
Page 8 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source: Food obtained from approved source.
Comments: The product contains a poisonous or deleterious substance and may not be sold or distributed. To request a Food Safety Inspector
visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product, contact the Business Center at (850)
245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source: Food obtained from approved source.
Comments: The product contains a poisonous or deleterious substance and may not be sold or distributed. To request a Food Safety Inspector
visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product, contact the Business Center at (850)
245-5520 or
[email protected].
Print Date: 8/2/2024
Page 9 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source: Food obtained from approved source.
Comments: The product contains a poisonous or deleterious substance and may not be sold or distributed. To request a Food Safety Inspector
visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product, contact the Business Center at (850)
245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 10 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 11 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 12 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 13 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 14 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 15 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.10 Adulterated.* Approved Source
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 16 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 17 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 18 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 19 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 20 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 21 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 22 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 23 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 24 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP USE ORDER
Reason: FS 500; FAC 5K-4 Violation of Florida Food Law.* Utensils, Equipment and Vending: Warewashing facilities:
installed, maintained, and used; test strips.
Comments: To request a Food Safety Inspector visit for written release when corrections have been made for request release of equipment,
contact the Business Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 25 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP USE ORDER
Reason: FS 500; FAC 5K-4 Violation of Florida Food Law.* Utensils, Equipment and Vending: Warewashing facilities:
installed, maintained, and used; test strips.
Comments: To request a Food Safety Inspector visit for written release when corrections have been made for request release of equipment,
contact the Business Center at (850) 245-5520 or
[email protected].
Print Date: 8/2/2024
Page 26 of 27
When the department or its duly authorized agent finds, or has probable cause to believe, that any food or food-processing equipment is in
violation of this chapter or any rule adopted under this chapter so as to be dangerous, unwholesome, fraudulent, or insanitary within the meaning
of this chapter, an agent of the department may issue and enforce a stop-sale, stop-use, removal, or hold order, which order gives notice that
such article or processing equipment is, or is suspected of being, in violation and has been detained or embargoed and which order warns all
persons not to remove, use, or dispose of such article or processing equipment by sale or otherwise until permission for removal, use, or disposal
is given by the department or the court. It is unlawful for any person to remove, use, or dispose of such detained or embargoed article or
processing equipment by sale or otherwise without such permission in accordance with 500.172 (1) Florida Statutes.
AN ADMINISTRATIVE HEARING IS AVAILABLE FOR ALL ORDERS, NOTICES, AND REPORTS IN THIS
SUPPLEMENTAL REPORT
If you wish to contest the Department's action, you have the right to request an administrative hearing to be conducted in accordance with
Sections 120.569 and 120.57, Florida Statutes and to be represented by counsel or other qualified representative. Your request for hearing must
contain:
1. Your name, address, and telephone number, and facsimile number (if any).
2. The name, address, and telephone number, and facsimile number of your attorney or qualified representative (if any) upon whom service of
pleadings and other papers shall be made.
3. A statement that you are requesting an administrative hearing and dispute the material facts alleged by the department, in which case you must
identify the material facts that are in dispute (formal hearing), or that you request an administrative hearing and that you do not dispute the facts
alleged by the department (informal hearing).
4. A statement of when (date) you received the Notice and the file number of this Notice.
Your request for a hearing must be received at the address shown on this Notice within twenty-one (21) days of receipt of this
Notice. If you fail to obtain a Release from this Notice or fail to request an administrative hearing within the twenty-one (21) day
HEARING WAIVER AND WAIVER OF RIGHTS
I, _____________________________________________________ the person in charge of Mary Jane's Bakery Co. hereby waive a notice and a
hearing as provided in Chapter 120, Florida Statutes and waive all rights as provided on the last page of this report.
____________________________________________
(Signature)
ACKNOWLEDGEMENT
I acknowledge receipt of a copy of this document.
(Signature of FDACS Representative)
(Signature of Representative)
GUISELLA URIBE, ENVIRONMENTAL SPECIALIST II
MICHAEL CALLAHAN, OWNER
Print Name and Title
FDACS-14325 Rev. 07/13
James Zheng, Environmental Specialist II
JULIO AZPURUA, SENIOR SANITATION AND SAFETY SPECIALIST
Print Date: 8/2/2024
Page 27 of 27
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight: