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Home My WebLink AboutTobacco Inspections in 2010Retail Tobacco Inspection Summary November 20 and 29, 2010 , 17 Establishments Yes No N/A 1. BOH Tobacco permit posted 16 1 2. Current Mass DOR license Posted 16 1 3. Cigarettes/packs of 20 or more sold 17 0 4. Self service in legal location 15 1 1 5. All humidors locked 1 2 14 6. Large yellow signs (MGL) posted 2 15 7. More than 1 register/small (MGL) sign 0 1 16 8. No smoking signs posted 5 12 9. Single cigar/health warning posted 0 13 4 10. Employee agreements on file 0 0 17 11. Vending machine/meets regulations 1 16 12. Violations found 15 2 13. "Under 27" items displayed 1 16 14. Liquor license 7 10 15. Marlboro Snus available 9 1 7 16. Camel Snus available 5 3 9 City of Fall River Massachusetts Department of Community Services PLANNING * HEALTH & HUMAN SERVICES LIBRARY * INSPECTIONAL SERVICES * ELECTIONS Health & Human Services Division Tobacco Cessation and Prevention WILLIANI A. FLANAGAN Mayor February 8, 2011 Mansfield Board of Health Attn: Mr. Scott Leite 6 Park Row Mansfield, MA 02048 Re: Educational Inspections on November 20 & 29, 2011 Dear Scott: HENRY VAILLANCOURT MD MPH Director Community Services MARILYN EDGE Tobacco Control Coordirlalor As follow-up to our meeting on February 3, 2011, enclosed please find copies of the inspection reports completed by Bob Collette. Where signage violations were found, new signage was provided free of charge to the retailer. If you have any questions please do not hesitate to contact me. Very truly yours, Marilyn Edo ME: enclosures Tobacco Retail Inspection Check Establishment: I&C(IM IL"111V/Y161 3-7? (AogrlGd �r- M&ms &e Employee Title: (Circle One) Owner Pu ose of Visit: cla one) outine Ins ection -/-Educatton--Complaint Received Inspection Retailer Requested Education If Unable to Complete:( Circle One) Inspection Date: Inspection Time:Employee Name: Name: P(a Manager Supervisor Clerk Failed Compliance Check Follow -Up Suspension of Permit Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? es ❑ NOD N/A 2 - Current Mass DOR license posted? es D No 3 - Only Cigarettes In packs of 20 or more sold (No'Loosles')? Ass D No 4 - Are Self Service Displays in Legal Location? DYes. o ❑ N/A 5 - All humidors are locked? DYe oD N/A 6 - Large yellow signs (MGL) posted? 0YOV6o 7 - If more than one registers, small yellow signs (MGL)posted? DYes D No N/A 8 - No smoking signs posted? As D No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? DYep'_1No ❑N/A 10 - Employee agreements on file (if required by local regulations)? (optional) DYes D No N/A 11 - If there is a vending machine, does it meet all regulations? DYes D No YA 12 - Were there any violations found? as D No 13 - Are any'Under 27' campaign Items displayed In the store? DYes O 14 - Does this establishment have a liquor license? s D No 15 - If available for sale, enter price ]not excise taxes of 6 pouch size of Marlboro Sn is 16 - If available for sale, enter price ]not excise taxes of 15 pouch size of Camel Snu 3_ If Yes to Question 12 Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Topics Discussed with Merchant: Checked Permit Regulationsrrobacco Sales Laws ❑ Retailers Responsibility ❑ Proper Identification ❑Compliance Checks (minors may look older) ❑ Penalties ❑1 ,6Required Signage Placement El Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑ Copy of Regulations Large Yellow (MGH) Sign(s) ❑ Small Yellow (MGH) Sign(s) EtGigar Health Warning Slgn(s) ❑ No Smoking Slgn(s) ❑Retailer KIUTralning Materials ❑ Sample Employee Agreements FDA regulation violations noted during Inspectlon: ❑ Flavored cigarettes available for sale El Cigarettes available with'low'mild' as descriptors ❑ Vending machines In a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: l 5� (� [' N �J FDA Advertising regulation violations I CJ noted during inspection: 0 Smokeless ads Tobacco Retail inspection Check Establishment: 14 Employee Title: (Circle One) Owner Purpose rfitle1t-----AQ1rcle One) outine Inspection/Education Complaint Received Inspection""` Retailer Requested Education If Unable to Comolete:(Clrcle One) Inspection Date: v J0-p m Inspection Time: EmIlloyee Name: Manager Supervisor Failed Compliance Check Follow -Up Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? Yes ❑ No ❑ N/A 2 - Current Mass DOR license posted? es ❑ No 3 - Only Cigarettes in packs of 20 or more sold (No'Loosles')? fes ❑ No 4 - Are Self Service Displays in Legal Location? es ❑ No El N/A 5 - All humidors are locked? DIYes ❑ No TVA 6 - Large yellow signs (MGL) posted? tads ❑ No OOOJ❑Yes 7 - If more than one registers, small yellow signs (MGL)posted? O No N/A 8 - No smoking signs posted? �16a ❑ No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? DYea ❑ No 96A 10 - Employee agreements on file (if required by local regulations)? (optional) DYes ❑ No N/A 11 - If there Is a vending machine, does it meet all regulations? LlYes ❑ No - /A 12 - Were there any violations found? ElYes No 13 - Are any'Under 27' campaign Items displayed In the store? OYes-No 14 - Does this establishment have a liquor license? OYe No 15 - If available for sale, enter price incl excise taxes of 6 pouch size of Marlboro Sn s 16 - If available for sale, enter price Ind excise taxes of 15 pouch size of Camel Snu If Yes to Question 12 Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Clerk Suspension of Permit ,Y�Checked Permit G31 Reviewed Regulations/Tobacco Sales Laws ❑ Retailers Responsibility ❑ Proper Identification ❑ Compliance Checks (minors may look older) ❑ Penalties ❑IT Inings Required Slgnage Placement ❑Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑Copy of Regulations arge Yellow (MGH) Sign(s) ❑Small Yellow (MGH) Sign(s) ❑Cigar Health Warning Sign(s) ❑ No Smoking Sign(s) ❑ Retailer Kit/Training Materials ❑ Sample Employee Agreements FDA regulation violations noted during inspection: ❑ Flavored cigarettes available for sale ❑ Cigarettes available with'low'mild' as descriptors ❑ Vending machines in a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during Inspection: ❑ Smokeless ads Tobacco Retail inspection Check Establishment: t%' �/� Inspection Date: ,lc/� C,�.crtic n may. IA4inn s j' _ I Inspection Time: ; y -a— � 1. V' r' �( (%� Employee Name: Employee Title: (Circle One) Owner Manager Supervl.� Purpose of Visit: (Circle One) Roouflne Inspectlon/Edu;@9on_-y Complaint Received Failed Compliance Check Follow -Up Inspection Retailer Requested Education Other -Please Specify If Unable to Compiete:(Clrcle One) Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? Yes D No N/A 2 - Current Mass DOR license posted? Yes 0 No 3 - Only Cigarettes in packs of 20 or more sold (No'Loosies')? #as 0 No 4 - Are Self Service Displays in Legal Location? Yes 0 No 0 NIA 5 -All humidors are locked? DYes ❑ No N/A 6 - Large yellow signs (MGL) posted? DYes�-No 7 - If more than one registers, small yellow signs (MGL)posted? DYes 0 No /A 8 - No smoking signs posted? Dyes) -No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? DYes VNo ON/A 10 - Employee agreements on file (if required by local regulations)? (optional) DYes 0 Nc#A 11 - If there is a vending machine, does It meet all regulations? DYes D No /A 12 - Were there any violations found? Ps D No 13 - Are any'Under 27' campaign Items displayed in the store? Dyes Offb 14 - Does this establishment have a liquor license? Dyes �_No 15 - If available for sale, enter price Intl excise taxes of 6 pouch size of Marlboro Sn s 16 - If available for sale, enter price incl excise taxes of 16 pouch size of Camel Snu If Yes to Question 12, Please Circle which Action was Taken: Educational Warning Given Referred to BOH $26 Fine $50 Fine $100 Fine Other Fine (Please Specify): Clerk Suspension of Persil Topics Discussed with Merchant: hermit Reviewed RegulatlonsfTobacoo Sales Laws ❑ Retailers Responsibility ❑ Proper Identification ❑ Compliance Checks (minors may look older) ❑ Penalties /Required Signage Placement ❑Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑ Copy of Regulations Large Yellow (MGH) Sign(s) Small Yellow (MGH) Sign(s) Alger Health Warning Sign(s) Smoking Sign(s) ❑ Retailer KIUTraining Materials ❑ Sample Employee Agreements FDA regulation violations noted during inspection: ❑ Flavored cigarettes available for safe ❑Cigarettes available wilh'low"mild' as descriptors ❑ Vending machines In a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted durina inspection: 0 Smokeless ads Tobacco Retail Inspection Check Establishment: C j/ yt) d e':-0 0 6)Pelr v/A hiz Em to ee Title: (Circle One) Owner Puroose of Visit: (Circle One) Complaint Received Inspection Retailer Requested Education If Unable to Complete:(Clrcle One) Inspection Date: Al (Tt/0 Inspection Time: Y_rr %' P)''� Employee Name: /),' A r % Manager Supervisor Clerk Failed Compliance Check Follow -Up Suspension of Permit Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? 4ysD No DN/A 2 - Current Mass DOR license posted? s 0 No 3 - Only Cigarettes In packs of 20 or more sold (No'Loosies')7 es 0 No 4 - Are Self Service Displays In Legal Location? IjYes0 NoON/A 5 - All humidors are locked? DYes 0 No 44INIA 6 - Large yellow signs (MGL) posted? DYes No 7 - If more than one registers, small yellow signs (MGL)posted? DYes Cl No ¢N/A 8 - No smoking signs posted? DYes L'No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? OYesy-No ON/A 10 - Employee agreements on file (if required by local regulations)? (optional) DYes 0 No O/A 11 - If there is a vending machine, does It meet all regulations? DYes 0 No N/A 12 - Were there any violations found? IVYes D No 13 - Are any'Under 27' campaign Items displayed in the store? DYes )too 14 - Does this establishment have a liquor license? DYes L J0 15 - if available for sale, enter price Ind excise taxes of 6 pouch size of Marlboro Sn Al is 'sr 16 -If available for sale, enter price Ind excise taxes of 15 pouch size of Camel Snu t � If Yes to Question 12 Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Tonics Discussed with Merchant: Checked Permit )evlewed Regulatlonsrrobacco Sales Laws ❑ Retailers Responsibility Proper Identification ❑ Compliance Checks (minors may look older) ❑ Penalties ❑ Trainings Required Signage Placement El Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑ Copy of Regulations Large Yellow (MGH) Sign(s) ❑Small Yellow (MGH) Slgn(s) Cigar Health Warning Signs) tSmoking Slgn(s) Retailer Kltrfralning Materials U FDA regulation violations noted during inspection: ❑ Flavored cigarettes available for sale ❑ Cigarettes available with'low"mild' as descriptors ❑ Vending machines In a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted durina inspection: ❑ Smokeless ads Tobacco Retail Inspection Check Establishment: vs, VS Inspection Date: lla-[' /d CA aL�� Inspection Time: Employee Name: Employee Title: (Circle One) Owner Manager gpervisor Purpose of Visit: (Circle One) Complaint Received Inspection Retailer Requested Education If Unable to Complete:( Circle One) Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? s O No DN/A 2 - Current Mass DOR license posted? s ❑ No 3 - Only Cigarettes In packs of 20 or more sold (No'Loostes')? Vi iss D No 4 - Are Self Service Displays In Legal Location? s D No D N/A 5 - All humidors are locked? OYes ❑ Nob/A 6 - Large yellow signs (MGL) posted? DYesANo 7 - If more than one registers, small yellow signs (MGL)posted? DYes -No O N/A 8 - No smoking signs posted? Dyes No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? Dyes No ON/A 10 - Employee agreements on file (if required by local regulations)? (optional) Was D No IA 11 - If there Is a vending machine, does it meet all regulations? Dyes D No /A 12 - Were there any violations found? Yes D No 13 - Are any'Under 27' campaign items displayed in the store? DYesd No 14 - Does this establishment have a liquor license? Dyes )_No 15 - If available for sale, enter price Intl excise taxes of 6 pouch size of Marlboro Sn s..Jr u) 16 -If available for sale, enter price inct excise taxes of 15 pouch size of Camel Snu /' I _ If Yes to Question 12, Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Clerk Failed Compliance Check Follow -Up Suspension of Permit Other -Please Specify Tonics Discussed with Merchant: 9)Checked Permit Reviewed Regulatlonsrrobacco Sales Laws ❑ Retailers Responsibility ❑ Proper Identification ❑ Compliance Checks (minors may look older) ❑ Penalties ❑Trainings �fRequired Signage Placement ❑ Smoke -Free Workplace Law D Retailer Kit Materials Materials Given: ❑ Copy of Regulations duarge Yellow (MGH) Sign(s) ry�mall Yellow (NIGH) Sign(s) YClgar Health Warning Sign(s) ,lo Smoking Sign(s) ❑ Retailer KII/Tralning Materials ❑ Sample Employee Agreements FDA regulation violations noted during Inspection: ❑ Flavored cigarettes available for sale ❑ Cigarettes available with'low'mild' as descriptors ❑ Vending machines In a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during inspection: 13 Smokeless ads Tobacco Retail Inspection Check Establishment:'W_C_St_1 r ,S x v CA(k", if. Employee Title: (Circle One) Owner Purpose of Visit: (Circle One) Complaint Received Inspeclicirr — Retailer Requested Education If Unable to Comolete:(Circle One) Inspection Date: 1 LC 1Q Inspection Time: r,,`/, rsy Employee Name: /<'i4il.xW Manager Supervisor Failed Compliance Check Follow -Up Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? s ❑ No ❑ N/A 2 - Current Mass DOR license posted? Y8s ❑ No 3 - Only Cigarettes in packs of 20 or more sold (No'Loosies')? 91yes0 No 4 - Are Self Service Displays in Legal Location? es ❑ No ❑ N/A 5 - All humidors are locked? Dyes ❑ No ANIA 6 - Large yellow signs (MGL) posted? Dyes fr No 7 - If more than one registers, small yellow signs (MGL)posled? DYes ❑ No /A 8 - No smoking signs posted? OYesp No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? DYes No ON/A 10 - Employee agreements on file (If required by local regulations)? (optional) DYes ❑ No NN/A 11 - If there is a vending machine, does it meet all regulations? QYes ❑ No N/A 12 - Were there any violations found? Pas D No 13 -Are any'Under 27' campaign Items displayed in the store? Dyes ONo 14 - Does this establishment have a liquor license? Yes ❑ No 15 -If available for sale, enter price incl excise taxes of 6 pouch size of Marlboro Sn s 16 - If available for sale, enter price incl excise taxes of 15 pouch size of Camel Snu If Yes to Question 12 Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Clerk Suspension of Permit Topics Discussed with Merchant: Checked Permit ##viewed Regulations/Tobacco Sales Laws ❑ Retailers Responsibility ❑ Proper identification ❑ Compliance Checks (minors may took older) ❑ Penalties ❑o11 Tralnings IRequired Slgnage Placement • Smoke -Free Workplace Law ❑Retailer Kit Materials Materials Given: O Copy of Regulations Large Yellow (MGH) Signs) ❑ Small Yellow (MGH) Slgn(s) r 'Cigar Health Warning Sign(s) �No Smoking Sign(s) Retailer KII/Tralning Materials ❑ Sample Employee Agreements FDA regulation violations noted during inspection: ❑ Flavored cigarettes avallable for sale ❑ Cigarettes available wlth 'low'mild' as descriptors ❑ Vending machines In a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during inspection: 0 Smokeless ads Tobacco Retail Inspection Check Establishment: ivy 761"— Inspection Date: //��Zr�/U / Iq „ /� �/ �.A Inspection Time: S ; Cl � �� (/ Employee Name: ��,',,"/�` Employee Title: (Circle One) Owner Manager �' Supervisor cl rr Purpose of -Visit; ____(Circle One) Inspection/Education -- -> Complaint Received Failed Compliance Check Follow -Up Suspension of Permit Inspection Retailer Requested Education If Unable to Complete:( Circle One) Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? es ❑ No ON/A 2 - Current Mass DOR license posted? s O No 3 - Only Cigarettes in packs of 20 or more sold (No'Loosles')? Feces D No 4 - Are Self Service Displays In Legal Location? 4Yes D No❑N/A 5 - All humidors are locked? DYes ❑ No C, /A 6 - Large yellow signs (MGL) posted? DYes 9wo 7 - If more than one registers, small yellow signs (MGL)posted? DYes D No /A 8 - No smoking signs posted? OYes,,r�No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? DYes yr "o DN/A 10 - Employee agreements on file (if required by local regulations)? (optional) DYes D No NIA 11 - If there is a vending machine, does it meet all regulations? DYes D No N/A 12 - Were there any violations found? es D No 13 - Are any'Under 27' campalgn Items displayed In the store? e o 14 -Does this establishment have a liquor license? DYes 9 o 15 - If available for sale, enter price Intl excise taxes of 6 pouch size of Marlboro Sn V(1 16 - If available for sale, enter price Intl excise taxes of 15 pouch size of Camel Snu If Yes to Question 12 Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Tonics Discussed with Merchant: 9'Cfiecked Permit D Reviewed Regulallonsfrobacco Sales Laws ❑ Retailers Responsibility ❑ Proper Identification ❑ Compliance Checks (minors may look older) ❑ Penalties ❑Tralnings 60 Required Signage Placpment ❑ Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑Copy of Regulations YL"arge Yellow (MGH) Sign(s) ❑Small Yellow (MGH) Sign(s) 'Cigar Health Warning Sign(s) t hlo Smoking Slgn(s) ❑ Retailer Kit/Training Materials ❑ Sample Employee Agreements FDA regulation violations noted during Inspection: ❑ Flavored cigarettes available for sale ❑Cigarettes available wlth'low'mild' as descriptors ❑ Vending machines In a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted durinc Inspection: mokeless ads Establishment:/jeyy1J Emcee Title: (Circle One) Putnose-ef-Wslt (Circle One) Tobacco Retail Inspection Check 6- y Inspection Date: JInspection Time: "Grriv rf' Employee Name: J4/1-� L V Owner Manager u ry sor ) J3o d_ dIng Insoentlon/Education Complaint Received Inspection Retailer Requested Education If Unable to Complete:(Clrcle One) Failed Compliance Check Follow -Up Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? es 0 No 0 N/A 2 - Current Mass DOR license posted? Yes 0 No 3.Only Cigarettes In packs of 20 or more sold (No'Loosles')? es ❑ No 4 - Are Self Service Displays in Legal Location? Pyes 0 No 0 N/A 5 - All humidors are locked? DYes 0 No LK/A 6 - Large yellow signs (MGL) posted? DYes No 7 - If more than one registers, small yellow signs (MGL)posted? DYes 0 No N/A 8 - No smoking signs posted? DYes#o 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? 0Ye5A_No ON/A 10 - Employee agreements on file (If required by local regulations)? (optional) DYes 0 NoVN/A 11 - If there Is a vending machine, does it meet all regulations? DYes 0 No N/A 12 - Were there any violations found? hYes 0 No 13 - Are any'Under 27' campaign Items displayed In the store? DYes gfNo 14 - Does this establishment have a liquor license? DYes -No 15 - If available for sale, enter price ]not excise taxes of 6 pouch size of Marlboro Sn is 17` 16 - If available for sale, enter price Inc? excise taxes of 15 pouch size of Camel Snu s X Educational Warning Given_ / Referred to BOH $25 Fine $50 Fine $100 Fine Clerk Suspension of Permit ,0?Ciiecked Permit ❑ Reviewed Regulationsfrobacco Sales Laws ❑ Retailers Responsibility ❑ Proper Identification ❑ Compliance Checks (minors may look older) ❑ Penalties ❑Trelnings f�Required Signage Placement ❑ Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: []Copy of Regulations Large Yellow (MGH) Sign(s) OSmall Yellow (MGH) Sign(s) / Cigar Health Warning Sign(s) �,y�vo Smoking Sign(s) ff❑�� Retailer Kitrrraining Materials ❑ Sample Employee Agreements FDA regulation violations noted during inspection: ❑ Flavored cigarettes available for sale ❑ Cigarettes available with'low'mild' as descriptors ❑ Vending machines In a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during inspection: 0 Smokeless ads Establishment: C:(t// 30 ()taee--9y6 J Tobacco Retail Inspection Check l F�)-7-A files- vt s Employee Title: (Circle One) Owner P o Visit: (Circle One) ection/E. - ducatloR Complaint Received Inspection k Retailer Requested Education If Unable to Complete:(Circle One) Inspection Date: 111,7- % Inspection Time: 3/ Employee Name: Manager Supervisor Failed Compliance Check Follow -Up Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? a AAes ❑ No 0 N/A 2 - Current Mass DOR license posted? -es 0 No 3 - Only Cigarettes In packs of 20 or more sold (No'Loosles')? VV,—s 0 No 4 - Are Self Service Displays in Legal Location? Yas 0 No 0 N/A 5- All humldors are locked? DYesEI No P/A 6 - Large yellow signs (MGL) posted? DYes No 7 - If more than one registers, small yellow signs (MGL)posted? - DYes 0 Not -N/A 8 - No smoking signs posted? DYes No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? OYese7 No ON/A 10- Employee agreements on file (if required by local regulations)? (optional) DYes 0 No�N/A 11 - If there Is a vending machine, does It meet all regulations? DYes 0 No N/A 12 - Were there any violations found? - ofe-S 0 No 13 - Are any'Under 27' campaign Items displayed In the store? DYes 00 14 - Does this establishment have a liquor license? DYes No 15 - if available for sale, enter price Inc] excise taxes of 6 pouch size of Marlboro Sn is t 16 - if available for sale, enter price Ind excise taxes of 15 pouch size of Camel Snu s If Yes to Question 12, Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): r) clerk Suspension of Permit Topics Discussed with Merchant: [3,16hecked Permit Regulationsfrobacco Sales Laws O Retailers Responsibility ❑ Proper Identification O Compliance Checks (minors may look older) ❑ Penalties ❑Trainings aRequ]red Signage Placement ❑ Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑ Copy of Regulations Large Yellow (MGH) Sign(s) ❑Small Yellow (MGH) Sign(s) Cigar Health Warning Sign(s) Alp Smoking Sign(s) ❑ Retailer KIUTraming Materials 0 Sample Employee Agreements FDA regulation violations noted during inspection: ❑ Flavored cigarettes available for sale ❑ Cigarettes available with'low'mild' as descriptors Vending machines in a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during Inspection: []Smokeless ads Tobacco Retail Inspection Check Establishment: / Itfj.1 j t,4 y}'Ze-lJ�J Employee Title: U (Circle One) Owner Purpose of Visit: (Circle One) Routine Inspection/Education Complaint Received Inspection Retailer Requested Education If Unable to Complete:(Circle One) Inspection Date: /'/'/')z,11 O Inspection Time: E o ame: Manager W Supervisor Clerk Failed Compliance Check Follow -Up Suspension of Permit Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? s 0 No NIA 2 - Current Mass DOR license posted? /'es 0 No 3 - Only Cigarettes in packs of 20 or more sold (No'Loosies')? as 0 No 4 - Are Self Service Displays In Legal Location? s O No 0 NIA 5 - All humidors are locked? OYes 0 No/A 6 - Large yellow signs (MGL) posted? OYes No 7 - If more than one registers, small yellow signs (MGL)posted? OYes O Ni9 N/A 8 - No smoking signs posted? 6YesO No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? Oyes V'No ON/A 10 - Employee agreements on file (if required by local regulations)? (optional) OYes O No h/A 11 - If there is a vending machine, does it meet all regulations? OYes O No CAIA 12 - Were there any violations found? Yes 0 No 13 - Are any 'Under 27' campaign Items displayed In the store? Oyes 0/46 14 - Does this establishment have a liquor license? Yes O No 15 -If available for sale, enter price Intl excise taxes of 6 pouch size of Marlboro Sn s aid/ 1 16 - If available for sale, enter price Intl excise taxes of 15 pouch size of Camel Snu 5 If Yes to Question 12.Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Permit I Regulations/Tobacco Sales Laws O Retailers Responsibility ❑ Proper Identification ❑ Compliance Checks (minors may look older) ❑ Penalties ❑Trainings Slgnage Placement ❑ Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑ Copy of Regulations Large Yellow (MGH) Sign(s) ❑ SSmall Yellow (MGH) Sign(s) ,gc2�1gar Health Warning Sign(s) Smoking Sign(s) %%❑ Retailer Kit/Training Materials FDA regulation violations noted during inspection: ❑ Flavored cigarettes available for sale ❑ Cigarettes available with'low"mild' as descriptors ❑ Vending machines in a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during Inspection: 0 Smokeless ads Tobacco Retail Inspection Check Establishment /l/utvspe""&'6 cl✓/ ? - pyw# Employee Title: (Circle One) Owner Purpose of Wslt: (Circle One) Complaint Received Inspection Retailer Requested Education If Unable to Complete:( Circle One) Inspection Date: O Inspectlon Time: G'J Emi2loype Name: Add anager Supervisor Clerk Failed Compliance Check Follow -Up Suspension of Permit Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed-Constructlon Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? 0YVN,0N1A 2 - Current Mass DOR license posted? s ❑ No 3 - Only Cigarettes In packs of 20 or more sold (No'Loosles')7 es ❑ No 4 - Are Self Service Displays in Legal Location? es ❑ No❑ N/A 5 - All humidors are locked? DYes ❑ No /A 6 - Large yellow signs (MGL) posted? DYes Gd No 7 - If more than one registers, small yellow signs (MGL)posted? OYes ❑ No WN/A 8 - No smoking signs posted? DYes)"No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? OYes ❑ No N1A 10 - Employee agreements on file (if required by local regulations)? (optional) CIYes ❑ No N/A 11 - if there Is a vending machine, does it meet all regulations? OYes ❑ NobrN/A 12 - Were there any violations found? #as ❑ No 13 - Are any'Under 27' campaign Items displayed In the store? Dyes EIN—o 14 - Does this establishment have a liquor license? Yes ❑ No IS- If available for sale, enter price Incl excise taxes of 6 pouch size of Marlboro Sn s 16 - if available for sale, enter price Incl excise taxes of 15 pouch size of Camel Snu " fr If Yes to Question 12 Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Tonics Discussed with Merchant: Checked Permit ❑ Reviewed RegulallonslTobacco Sales Laws ❑ Retailers Responsibility ❑ Proper Identification ❑ Compliance Checks (minors may look older) • Penalties 99Tralnings [il'Required Signage Placement VV❑Smoke-Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑ Copy of Regulations Large Yellow (MGH) Sign(s) ❑ Small Yellow (MGH) Sign(s) ❑ Cigar Health Warning Sign(s) �ko Smoking Sign(s) ❑ Retailer Klt/Training Materials ❑ Sample FDA regulation violations noted during inspection: ❑ Flavored cigarettes available for sale ❑ Cigarettes available wilh'low'mild' as descriptors ❑ Vending machines in a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during inspection: 0 Smokeless ads Tobacco Retail Inspection Check Establishment: /Er 1/v N Inspection Date: /// all C/ Inspection Time: (S , �!`j✓ J N / Employee Name: n,L(� P Employee Title: (Circle One) Owner Manager Supervisor Clerk Pros Ik ------ (GrAce One) I e Inspectlon/Educalion Complaint Received Failed Compliance Check Follow -Up Suspension of Permit Inspection Retailer Requested Education Other -Please Specify If Unable to Complete:( Circle One) Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? es D No DN/A Topics Discussed with Merchant: .checked Permit 2 - Current Mass DOR license posted? - as ❑ No ,Reviewed Regulationsrrobacco Sales Laws 3 - Only Cigarettes In packs of 20 or more sold (No'Loostes')7 s ❑ No ❑ Retailers Responsibility ❑ Proper identification 4 - Are Self Service Displays In Legal Location? es D NoC1N/A D Compliance Checks (minors may look older) 5 - All humidors are locked? 5 -All humidors are locked? ElYe kN DYe o N ,_ ❑Penalties ❑ Tralnings Required Slgnage Placement 6 - Large yellow signs (MGL) posted? DYeskNo 7 - If more than one registers, small yellow signs (MGL)posted? DYes D No I JNIA ❑ Smoke -Free Workplace Law 8 - No smoking signs posted? Dyes 11No ❑ Retailer Kit Materials 9 - If single cigars are sold, health warning sign posted where hand -rolled DYes No o Materials Given: or manufactured cigars outside of original package are displayed? ONIA opy of Regulations erge Yellow (MGH) Sign(s) 10 - Employee agreements on file (if required by local regulations)? (optional) DYes D No/A V ❑Small Yellow (MGH) Slgn(s) Cigar Health Warning Slgn(s) Smoking Sign(s) 11 - If there Is a vending machine, does it meet all regulations? oyes D No �fJ/A 12 - Were there any violations found? es D No �pJ,�fo -L7 Retailer KIUTralning Materials 13 -Are any'Under 27' campaign Items displayed In the store? DYeso []Sample Employee Agreements 14 - Does this establishment have a liquor license? Dyes No FDA regulation violations noted E(r 15 - If available for sale, enter price [not excise taxes of 6 pouch size of Marlboro Sn is `� during inspection: ❑ Flavored cigarettes available for sale for Ind taxes of 15 size of Camel Sm /-f `� 16 - If available sale, enter price excise pouch r ❑ Cigarettes available with'low"mild' as descriptors o Question 12 Please Circle which Action was Taken: O Vending machines In a non -adult i ' Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine only establishment Other Fine (Please Specify): ❑Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during Inspection: 148mokeless ads r Establishment: Employee Title: (Circle One) Purpose of Visit:_ fClrcle One) Tobacco Retail Inspection Check c � inspection Date: /� �6 Inspection Time: t� Employee Name: t-Tt Owner Manager Supervisor P�ullne Inspecllon/EdueatioO Complaint Received Inspection Retailer Requested Education If Unable to Complete:(Circle One) Failed Compliance Check Follow -Up Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? es ❑ No ❑ N/A 2 - Current Mass DOR license posted? es ❑ No 3. Only Cigarettes In packs of 20 or more sold (No'Loosiee)7 Vas ❑ No 4 - Are Self Service Displays in Legal Location? ElYes ❑ No /A 5 - All humidors are locked? DYesO No N"/A 6 - Large yellow signs (MGL) posted? s ❑ No 7 - If more than one registers, small yellow signs (MGL)posted? oYes ❑ No N/A 8 - No smoking signs posted? A s ❑ No 9 - If single clgars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? DYes ❑ No EJVA 10 - Employee agreements on file (if required by local regulations)? (optional) DYes ❑ No❑ /A 11 - If there is a vending machine, does it meet all regulations? pk�s ❑ No C N/A 12 - Were there any violations found? []Yes W No 13 - Are any'Under 27' campalgn items displayed in the store? Dyes Y'_No 14 - Does this establishment have a liquor license? 9WIsO No 15 - If available for sale, enter price incl excise taxes of 6 pouch size of Marlboro Sn s 16 -If available for sale, enter price Incl excise taxes of 15 pouch size of Camel Snu If Yes to Question 12, Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Clerk Suspension of Permit I Topics Discussed with Merchant: hecked Permit 77777❑ Reviewed Regulations/Tobacco Sales Laws ❑ Retailers Responsibility ❑ Proper Idenllficallon ❑ Compliance Checks (minors may look older) ❑ Penalties ❑Tralnings Mequlred Signage Placement Smoke -Free Workplace Law Retailer Kit Materials Materials Given: O Copy of Regulations arge Yellow (MGH) Signs) ❑ Small Yellow (MGH) Sign(s) ❑ Cigar Health Warning Sign(s) ❑ No Smoking Sign(s) ❑ Retailer Kit/Tralning Materials ❑ Sample Employee Agreements FDA reaulation violations noted during inspection: ❑ Flavored cigarettes avallable for sale ❑Cigarettes available with'low'mild' as descriptors ❑Vending machines in a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: ;1 ��{ `r N r'7 7�t �i✓jlti �7 FDA Advertising regulation violations / A noted during Inspection: ❑Smokeless ads Tobacco Retail Inspection Check Establishment: ��D7✓�'!='"�� y Inspection Date: Inspection Time: 4 Employee Title: (Circle One) Owner Manager Supervisor Clerk Purpose of Visit: (Circle One) Routine Inspection/Education Complaint Received Failed Compliance Check Follow -Up Suspension of Permit Inspection Retailer Requested Education If Unable to Complete:( Circle One) Out of Business Closed Closed -Construction Too Busy Other -Please Specify No Longer Sells Tobacco Closed -Seasonal Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? q Cl NoD N/A 2 - Current Mass DOR license posted? es D No 3 - Only Cigarettes In packs of 20 or more sold (No'Loostes')7 Yes D No 4 - Are Self Service Displays in Legal Location? es D No D N/A 5 - All humidors are locked? DYes D No "/A 6 - Large yellow signs (MGL) posted? DYes o 7 - If more than one registers, small yellow signs (MGL)posted? DYes D No N/A 8 - No smoking signs posted? DYesyNo 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? DYeSANo ON/A 10 - Employee agreements on file (If required by local regulations)? (optional) DYes D No VN/A 11 - If there Is a vending machine, does it meet all regulations? DYes D No PN/A 12 - Were there any violations found? i es D No 13 - Are any'Under 27' campaign Items displayed In the store? DYes 9/110 14 - Does this establishment have a liquor license? OYes#o 15 - If available for sale, enter price Inc] excise taxes of 6 pouch size of Marlboro Sn rs 16 - If available for sale, enter price Inc] excise taxes of 15 pouch size of Camel Snu If Yes to Question 12, Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $60 Fine $100 Fine Other Fine (Please Specify): Topics Discussed with Merchant: P"Ghecked Permit [�Revlewed Regulallonsrrobacco Sales Laws ✓❑ Retailers Responsibility ❑ Proper Identification ❑ Compliance Checks (minors may took older) Penalties OJTTrainings Ot "equired Slgnage Placement ❑Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑ Copy of Regulations Large Yellow (MGH) Sign(s) ❑ Small Yellow (MGH) Sign(s) ,aelgar Health Warning Sign(s) Ob Smoking Sign(s) ❑ Retailer Kitrrraining Materials ❑ Sample Employee Agreements FDA regulation violations noted during Inspection: ❑ Flavored cigarettes available for sale ❑ Cigarettes available with'low' 'mild' as descriptors ❑ Vending machines In a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during inspection: 0 Smokeless ads Tobacco Retail Inspection Check Establishment: &-rdr f!/ '),11"p 307 0" I , 'ye. jq"&Ij Employee Title: (Circle One) Owner Purpose of Via w— (Girc(e One) outlne Inspection/Educalion f Complaint Received Inspection Retailer Requested Education If Unable to Comolete:(Circle One) Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? s D NOON/A 2 - Current Mass DOR license posted? ke a[] No 3 - Only Cigarettes In packs of 20 or more sold (No'Loosies')? M(res D No 4 - Are Self Service Displays In Legal Location? es D No ON/A 5 - All humidors are locked? DYes D No 01A 6 - Large yellow signs (MGL) posted? DYes o 7 - If more than one registers, small yellow signs (MGL)posted? DYes D No �N/A 8 - No smoking signs posted? 9kes D No 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? DYes D No # 10 - Employee agreements on file (if required by local regulations)? (optional) DYes D No //A 11 - if there Is a vending machine, does It meet all regulations? DYes D NoOI /A 12 - Were there any violations found? es D No 13 - Are any'Under 27' campaign Items displayed In the store? DYes 0h6 14 - Does this establishment have a liquor license? DYes IIND 15 - If available for sale, enter price Ind excise taxes of 6 pouch size of Marlboro Sn is 16 - If available for sale, enter price incl excise taxes of 15 pouch size of Camel Snu If Yes to Question 12, Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Inspection Date: /#JZ' 0 Inspection Time: Employee Name: Manager Supervisor Failed Compliance Check Follow -Up Other -Please Specify Clerk Suspension of Permit Topics Discussed with Merchant: Checked Permit ❑ Reviewed Regulations/Tobacco Sales Laws Retailers Responsibility ❑ Proper identification ❑ Compliance Checks (minors may look older) ❑ Penalties ❑ Tralnings f'Requlred Slgnage Placement • Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: ❑Copy of Regulations .Large Yellow (MGH) Sign(s) ❑ Small Yellow (MGH) Sign(s) ❑ Cigar Health Warning Sign(s) ❑ No Smoking Sign(s) ❑ Retailer Kitrrraining Materials FDA regulation violations noted during Inspection: ❑ Flavored cigarettes available for sale ❑Cigarettes available with'low'mild' as descriptors ❑Vending machines in a non -adult only establishment ❑Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during Inspection: Cl Smokeless ads Ckm L Tobacco Retail Inspection Check Establlshment: OuA 1tt61Z—r Inspection Date: Ins ectio Time: ' '7QhV tom. 1111'lts 71fy'l Employee Name: w� Employee Title: (Circle One) Owner Manager S ewlsor Clerk Purpose of Visit: (Circle One) Routine Inspectlon/Education Complaint Received Failed Compliance Check Follow -Up Suspension of Permit Inspection Retailer Requested Education Other -Please Specify If Unable to Complete:(Clrcle One) Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? s D No DN/A Topics Discussed with Merchant: hacked Permit 2 - Current Mass DOR license posted? Dyes o teviewed Regulations/Tobacco Sales Laws 3 - Only Cigarettes in packs of 20 or more sold (No'Loosies')? es ❑ No etailers Responsibility ❑ Proper Identification 4 - Are Self Service Displays in Legal Location? AYea D No DN/A ❑Compliance Checks (minors may look older) 5 - All humidors are locked? Wkes D No D N/A D Penalties 6 - Large yellow signs (MGL) posted? Dyes o ❑Tralnings quired Slgnage Placement 7 - If more than one registers, small yellow signs (MGL)posted? DYes ❑ Noh1A ❑ Smoke -Free Workplace Law 8 - No smoking signs posted? DYesAo ❑ Retailer Kit Materials 9 - If single cigars are sold, health warning sign posted where hand -rolled DYes f�i o Materials Given: or manufactured cigars outside of original package are displayed? DN/A ❑ Copy of Regulations Marge Yellow (MGH) Sign(s) 10 - Employee agreements on file (if required by local regulations)? (optional) DYes D No /A ❑Small Yellow (MGH) Sign(s) 11 -If there Is a vending machine, does it meet all regulations? DYes D No ,,gar Health Warning Slgn(s) eo Smoking Signs) 12 - Were there any violations found? es O No D Retailer KII/Training Materials 13 - Are any'Under 27' campalgn Items displayed In the store? Dyes *0 ❑Sample Employee Agreements 14 - Does this establishment have a liquor license? P6s D No FDA regulation violations noted 15 - If available for sale, enter price Incl excise taxes of 6 pouch size of Marlboro Sn AS during Inspection: ❑ Flavored cigarettes available for sale 16 - If available for sale, enter price [not excise taxes of 15 pouch size of Camel Snu i ❑ Cigarettes available wilh'low'mild' as descriptors If Yes to Question 12 Please Circle which Action was Taken: ❑ Vending machines In a non -adult Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine only establishment Other Fine (Please Specify): ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during Inspection: ❑ Smokeless ads Tobacco Retail Inspection Check Establishment: e,e�jaAi VT_ I'la-1s /�-16/ Employee Title: (Circle One) Owner purpose of Visit: (Circle One) 'Routine_ InspectioNEduoation' Complaint Received Inspection Retailer Requested Education If Unable to Complete:( Circle One) Inspection Date: Inspection Time: Employee Name: Manager Supervisor Clerk Failed Compliance Check Follow -Up Suspension of Permit Other -Please Specify Out of Business Closed No Longer Sells Tobacco Closed -Seasonal Closed -Construction Too Busy Other -Please Specify 1 - Is Current Board of Health Tobacco retailer permit posted? s O No O N/A 2 - Current Mass DOR license posted? s O No 3 - Only Cigarettes in packs of 20 or more sold (No'Loosles')? 9IMsO No 4 - Are Self Service Displays In Legal Location? _ es O NoON/A 5 - All humidors are locked? OYes O No AA 6 - Large yellow signs (MGL) posted? OYeSAo 7 - If more than one registers, small yellow signs (MGL)posted? OYes O NoATN/A 8 - No smoking signs posted? Oyes o 9 - If single cigars are sold, health warning sign posted where hand -rolled or manufactured cigars outside of original package are displayed? OYesVNo ❑N/A 10 - Employee agreements on gle (if required by local regulations)? (optional) OYes O 4NIA 11 - If there Is a vending machine, does it meet all regulations? Oyes O NoJ?N/A 12 - Were there any violations found? 96s O No 13 - Are any'Under 27' campaign items displayed in the store? Oyes C00 14 - Does this establishment have a liquor license? 916s O No 15 - If available for sale, enter price Incl excise taxes of 6 pouch size of Marlboro Sn is x Dr 16 - If available for sale, enter price Ind excise taxes of 15 pouch size of Camel Snu If Yes to Question 12, Please Circle which Action was Taken: Educational Warning Given Referred to BOH $25 Fine $50 Fine $100 Fine Other Fine (Please Specify): Topics Discussed with Merchant: ywhacked Permit %mReviewed Regulationslrobacco Sales Laws ❑ Retailers Responsibility ❑ Proper Identlncation OCompiiance Checks (minors may look older) ❑ Penalties Required Signage Placement ❑Smoke -Free Workplace Law ❑ Retailer Kit Materials Materials Given: O Copy of Regulations Aarge Yellow (MGH) Sign(s) ❑ Small Yellow (MGH) Sign(s) �igar Health Warning Slgn(s) J�J[�o Smoking Sign(s) Kl Retailer KIVTralning Materials ❑ Sample Employee Agreements FDA regulation violations noted during inspection: • Flavored cigarettes available for sale ❑Cigarettes available wilh'low'mild' as descriptors ❑Vending machines in a non -adult only establishment ❑ Sale of loose cigarettes Notes/Comments: FDA Advertising regulation violations noted during Inspection: 0 Smokeless ads