First and Ten LLC in Venice

Comments: Check-Back release issued for Stop Sale Order. All hot sauce bottles have been relabeled with 'contains milk' directly underneath ingredient panel. 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) ANDY DUFFY, OWNER 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: *99997182191532*

Comments: 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. Stop Sale Order issued. Food establishment can visit https://foodpermit.fdacs.gov or contact the Business Center at (850) 245-5520 when corrections have been made and/or when required documents have been obtained to request food safety inspector visit for written release of product. Re-inspection visit required issued for food establishment. A re-inspection will be conducted on or about 14 days. 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. Food Label Guide, Reportable Food Registry (RFR), and FDA Food Facility registration provided to food establishment owner. Please send trace forward documentation, specifically who, when, and amount of hot sauce distributed to [email protected] when obtained. FDACS 14205 Rev. 07/13 Page 2 of 3 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 *99997182191491* Visit # 9999-7182-1914-91 Bureau of Food Inspection Attention: Business Center 3125 Conner Boulevard, C-26 Tallahassee, FL 32399-1650