HomeMy WebLinkAbout4 South Main (Citgo) - 2013TOWN OF MANSFIELD, MASSACHUSETTS
Six Park Row, Mansfield, MA 02048
January 27, 2014
Mrs. AnjanaPatel
Four Corners Citgo
4 South Main Street
Mansfield, MA 02048
Dear Mrs. Patel,
I have received your request for a hearing regarding the suspension of your license for selling
tobacco products from your representative Dinesh Patel.
In meeting with your representative On January 27, 2014 at my office, he requested that the
hearing be held on February 6, 2014, instead of February 3`d to allow for an extension of time.
The notice of suspension and embargo will not go into effect until after the hearing on February
6, 2014 at 7:10 PM. The hearing will be held in meeting room 2 A1B, at the Town Hall, 6 Park
Row. At the hearing the Board of Health may modify or sustain the notice.
If I can be of assistance, please do not hesitate to contact me.
3COLL LC 1L�/ Caltf. _ Lllf
On Janua 7, 2014 at
Copy: Marilyn Edge, WBC&F Tobacco and Alcohol Prevention Collaborative
I j ., Z") - t � �
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c Od t�,
yy�
TOWN OF MANSFIELD, MASSACHUSETTS
Six Park Row, Mansfield, MA 02048
January 15, 2014
Mrs. Anjana Patel
Four Corners Citgo
4 South Main Street
Mansfield, MA 02048
Dear Mrs, Patel,
On May 18, 2013, a compliance check of youth access to tobacco by purchase was performed by
the Western Bristol County and Foxborough Tobacco and Alcohol Prevention Collaborative,
further referred to as "the Collaborative", on behalf of the Town of Mansfield's Board of Health.
The compliance check on that day, revealed that Four Corners Citgo, which is owned by you,
was in violation of the Mansfield Board of Health Regulation Affecting Smoking and the Sale,
Vending and Distribution of Tobacco and Nicotine Products Article 5: Sale of Tobacco and
Nicotine Products, Section IA, by selling cigarettes to a 17 year -old buyer.
In a letter dated May 23, 2013 from the Collaborative, you were notified of a hearing to be held
on June 6, 2013 regarding this violation and possible suspension of your tobacco sales permit.
You attended that hearing and admitted to making the sale. The Board of Health closed the
hearing and made a motion regarding this matter during its meeting that evening.
The Board of Health moved and voted that you receive an official warning letter and work with
the Collaborative to develop within thirty (30) days a written action plan on the policies and
procedures that the business will enact to prevent the sale of tobacco products to minors. You
were notified of this determination by the Board of Health through the Collaborative in a letter to
you dated June 10, 2013.
In a letter dated December 6, 2013, I reminded you of your responsibility in this matter and
requested that you attend the January 8, 2013 meeting of the Board of Health to provide evidence
of compliance. You did not attend the meeting but Mr. Dinesh Patel did attend the meeting as
your representative. No evidence of compliance was provided.
Patel
January 15, 2014
Page 2
At the January 8°i meeting, the Board of Health voted to suspend the license for selling tobacco
products for Four Corners Citgo, starting on Monday, January 27, 2014 at 9:00 AM for no less
than three (3) days and the suspension will continue until the board receives Mrs. Patel's written
action plan on the policies and procedures that his business will enact to prevent the sale of
tobacco products to minors, as described in the minutes of June 6, 2013 and noted in the letter
dated December 6, 2013.
During the suspension, all tobacco products shall be embargoed. At 11:00 AM on January 27,
2014 all tobacco and nicotine products shall be inventoried, packaged and sealed in the presence
of a Board of Health representative. You will need to provide sufficient cartons and sealing tape
for packaging. The embargoed product shall be removed from the premises. When the
suspension is lifted, the embargoed product shall be opened and inventoried in the presence of a
Board of Health representative before re -stocking the product.
You are entitled to a hearing regarding the suspension of your permit. A request for a hearing
shall be made in writing and filed in the office of the Board of Health within five (5) days of the
receipt of this notice. A requested hearing before the Board of Health shall be held no later than
fourteen (14) days after the request is received. Upon receipt of the request, you will be notified
in writing of the time and place of the hearing.
If I can be of assistance, please do not hesitate to contact me.
Youp'tru71y,
Scot ite, Health Agent
Served by hand at Four Q'orners Citgo, 4 South Main Street,
By Scott Leite, Health e
On January 15, 2014 at '�? :10M.
Cory: Marilyn Edge, WBC&F Tobacco and Alcohol Prevention Collaborative
TOWN OF MANSFIELD, MASSACHUSETTS
Six Park Row, Mansfield, MA 02048
December 6, 2013
Mrs. Anjana Patel, President
Four Corners Citgo
4 South Main Street
Mansfield, MA 02048
Dear Mrs. Patel,
On June 6, 2013 the Board of Health made the following motion regarding the sale of tobacco to
a minor at this location:
"Mr. Healey made a motion that Ms. Edge send an official warning letter to the owner of Four
Corners Citgo and the owner work with the town's Tobacco Compliance people over the next 30
days to develop a written action plan on the policies and procedures that the business will enact
to prevent the sale of tobacco products to minors. Mr. McClean seconded the motion. Motion
passed 4-0-0."
Please attend the Board of Health meeting on January 8, 2014 at 7:00 PM to provide evidence of
compliance. The meeting will be held on the first floor meeting room, opposite the Health
Department Office, at 6 Park Row.
Health Agent
CERTIFIED MAIL: 7003 1680 0006 9325 6190
C: Marilyn Edge, WBC&F Tobacco and Alcohol Prevention Collaborative
Scott Leite
From: Marilyn Edge <wbristoltobaccoalcohol@gmail.com>
Sent: Thursday, December 05, 2013 8:19 AM
To: Scott Leite
Subject: no word as of 8:15 a.m. today
from Four Corners Citgo. On 10/9/13 Mr. Patel called me to ask that I fax him a blank Employee Agreement so
that he could copy it and have all of his employees sign one. I did that. I have not heard back from him.
from Mansfield Gas. I sent him a duplicate training packet, certified mail, on October 10, 2013. That certified
mail was accepted on October 12, 2013. I have not heard back.
I will be at the meeting with the Commissioner this a.m. If you need me please leave a message on my cell
phone.
Marilyn Edge
Western Bristol County & Foxborough
Tobacco & Alcohol Prevention
One Government Center, 4th fl
Fall River, MA 02722
Office: 508-324-2423
Cell: 774-488-9341
Fax: 508-324-2429
Western Bristol County & Foxborough
Tobacco & Alcohol Prevention Collaborative
One Government Center, 4th A
Fall River, MA 02722
Office: 508 324 2423
Cell: 774 488 9341
Fax: 508 324 2429
Serving
Boards of Health in
Attleboro
N. Attleboro
Berkley
Dighton
Fall River
Foxborough
Mansfield
Norton
Seekonk
Somerset
Swansea
Taunton
Westport
Marilyn Edge, Director
Email: WBristolTobaccoAlcohol@gmail.com
May 23, 2013
Four Corners Citgo
Attn: Mr. Anjana Patel, President
4 South Main St.
Mansfield, MA 02048
Re: Meeting of the Board of Health
Dear Mr. Patel:
On May 18, 2013 Four Comers Citgo at 4 South Main St., Mansfield,
MA was found in violation of Town of Mansfield Board of Health
Regulation Affecting Smoking and the Sale, Vending and Distribution of
Tobacco and Nicotine Products, Article 5, Section IA when a sale of
Marlboro cigarettes was made to a 17-year old student. The May 18,
2013 sale is the first offense violation for this location and requires a
written warning and an appearance- efore the Mansfield Board of Health.
Please consider this letter your only written warning.
You are required to appear for a Hearing before the Mansfield Board of
Health on Thursday, June 6, 2013 at 7:45 p.m. This Hearing will be
held in Meeting Room 2A-B on the second floor of the Town Hall. At
this meeting the Board of Health will discuss this violation and how it
will affect your tobacco sales permit.
If you have any questions please do not hesitate to contact me or
Mansfield Health Agent, Scott Leite, at 508-261-7366.
Yours in Health,
Marilyn Edge
Mail: Certified Mail — Return Receipt
CC: Regular Mail
/CC: Mansfield Health Dept.
Western Bristol County & Foxborough
Tobacco & Alcohol Prevention Collaborative
One Government Center, 4th fl.
Fall River, MA 02722
Marilyn Edge, Director
Office: 508 324 2423
Email: WBristolTobaccoAlcohol@gmail.com
Cell: 774 488 9341
Fax: 508 324 2429
June 10, 2013
Serving
Boards of Health in
Four Corners Citgo
0
Attleboro
Attn: Mr. Anjana Patel, President
4 South Main St.
N. Attleboro
Mansfield, MA 02048
Berkley
Re: Board of Health Hearing on June 6, 2013
Dighton
Dear Mr. Patel:
Fall River
After the Hearing on June 6, 2013, the Mansfield Board of Health
Foxborough
Ordered that you have 30 days, from receipt of this letter, to put in
•
writing a policy for training your employees to comply with the Board of
Mansfield
Health Regulations on Sales of Tobacco Products. You will need to
submit that policy to the Board of Health for approval. I advised them
Norton
that I was available to help you with that policy.
Seelconk
Enclosed please find two flyers for 90-minute Retailer Tobacco Trainings
Somerset
that are being held in Fall River on Monday, June 17, 2013 and in North
•
Attleboro on Monday, June 24, 2013. There are multiple trainings being
Swansea
held on each day. Please be advised that these trainings are for store
'
owners and managers, NOT sales clerks. This training will help you
Taunton
create a policy for your establishment that will help you comply with
Westport
local, state and FDA regulations.
Please contact me at the telephone or email listed on the flyer and let me
know which session you will be able to attend. After the trainings we
can meet and outline a policy to be presented to the Board of Health for
approval.
Yours in Health,
/,//
Marilyn Edge
Enclosures
Mail: Certified — Return Receipt'
CC: Regular Mail
CC: Mansfield Health Dept.
Western Bristol County & Foxborough
Tobacco & Alcohol Prevention Collaborative
One Government Center, 41h fl.
Fall River, MA 02722
Office: 508 324 2423
Cell: 774 488 9341
Fax: 508 324 2429
Serving
Boards of Health in
Attleboro
N. Attleboro
Berkley
Dighton
Fall River
Foxborough
Mansfield
Norton
Seekonk
Somerset
Swansea
Taunton
Westport
Marilyn Edge, Director
Email: WBristolTobaccoAlcohol@gm ail. coni
September 18, 2013
Four Corners Citgo ((
Attn: Mr. Anjana Patel { { �'
4 South Main St. LLL ���JJJ
Mansfield, MA 02048
Re: Continued Hearing Scheduled
Dear Mr. Patel:
I have been advised by Scott Leite that the continued Hearing has been
scheduled for Thursday, October 3, 2013 at 7:00 p.m. Your presence
is required at that time.
Upon receipt of this letter please forward a copy of the employment
policy you created after the Retailer Training Program on June 24,
2013. As I am sure you recall, the Mansfield Board of Health
suggested that you create such a policy at the original Hearing on June
6, 2013. If you have created that policy I will need to review it prior to
the October 3, 2013 Hearing. As we discussed on the telephone, you
may fax it to me at 508-324-2429.
If you have any questions please contact me.
Yours in Health,
Marilyn Edi
Mail: Certified — Return Receipt
CC: Regular Mail
CC: Mansfield Health Dept.
It is illegal'
to sell tobacco
products
to anyone under
the age of IS
CAS11 MR;IS'fEIZ 1D QUICK IZEFFIO NCE GUIDE
FAMILY FOOD MART
MANSFIELD MA 02048
Every employee at this store has the legal and moral responsibility to control the sale and
distribution of age restricted items to ensure these items do not get to minors!
LEGAL RESPONSIBILITY IS ALWAYS THE STORE PERSONNELS ! !
age restricted Products :
PRODUCT LEGAL AGE TO PURCHESE VALID
1'olmoco is 30 or le;,s
l.otfoy Iti 30of less
ID CHECK BUT FIRM NO DEBATES - "IT'S THE LAW!"
Match the ID photo to the person's face .is the person on the ID the person presenting
to you ?
2 . Date of birth . Is the person of legal age to make the item purchase? One you're
presented with an acceptable ID the ACTUAL DOB must be enterd into the register
for all tobacco & alcohol item
3 . Expiration date . An Expiration ID is no longer a VALID ID We only accept Valid ID
4 . Feel the ID for evidence of tampering All ID's must be handled by the employee
ask customer to remove ID FROM WALLET ETC. AT all times. Anything less is
unacceptable.
5 . Out of state ID's require a 2"' form of identification e.g. credit card
6 . If still unsure if the ID is valid, ask the customer to verify some ID information
his/her date of birth spelling of the last name ,city/town are good examples.
7 . THIRD PARTY SALES: When 2 or more people are part of the purchase of an age-
resricted products all must pass age verification with valid id's If not' NO SALE!!
RESPOiNSIBLE St<,l,I,l1' C EVEIZs!OM,� JOB ITS JNIENER OIa'I'ktlNAL
It is illegal
to sell tobacco
products
to anyone under
the age of 18
1 FOUR ('(WNHCI'I'(iO
`�OUI I l YinlVi �;.I.
MAIM;l WH) Yin-020dS
Employee Tobacco Training Program
1),Include Tobacco Product sales Policy in a comprehensive Policy &
Procedures Manual for all Age -Restricted Product Sales. This manual
will be presented by management to all new & existing employees for
their review and signature.
2). Generating an " ID Quick Reference Guide" to be posted at each
register to assist employees in adhering to ID Policy & Procedures
3). Continuous Reinforcement of the Importance of Responsible
Selling Of Age -Restricted Products Offered at the Store.
Tobacco and Lottery sales account for 81 Out Of Every
90 Dollar Handled By Four Conner Citgo 's Employees.
Emphasis On the Importance of Community Responsibility,in
Addition to Legal Responsibility , For This Store To Control
the Sale and Distribution of Age -restricted Items To Ensure
These Items Do Not Get Sold To Minors.
Continuous Reinforcement Will Include Individual Counseling
Sessions With All Employees Throughout the Calendar Years,
Posting of Signs Stating the Store Responsibility For Both
Employees and Customers, Refreshing All Signs Twice a Year.
Four Corner Citgo Will Do This Training Every 3 Months.
If Any Employees or Relative Sell Cigarette To Minors They
Will Not Get Paid For 2 Weeks And If Employees Still Sell
Tobacco Product To Minors Employee Will Receive Suspension
Letter.
Explore conducting Own Compliance Checks at Store Level
''Hill,.`;
Every employee at this store has the legal and moral responsibility to
control the sale and distribution of age -restricted items to ensure these
items do not get sold to minors !
LEGAL RESPONSIBILTY IS ALWAYS THE STORE PERSONNELS ! !
AGE-RESRICTED PRODUCTS POLICY
Objective: To be in compliance with all federal and state laws concering
the purchase of age -restricted products.
PROCEDURES:
a) State Law specifically restricts the sale of certain products that this store
to customers that are not of legal age including any Employees of this
store.
b) Penalties for violation these statutes range fro monetary fines for both
the store and the individual to revocation of the license on a temporary
or permanent basis.
c) This store and its Employees must use their utmost diligence and follow
set rules & procedures governing the sale of these items. When in doubt
someone's age, always ask for a valid I.D
d) The following items are age -restricted
• All Tobacco Products / Rolling Papers
• All Lottery Products
PRODUCTS LEGAL AGE TO PURCHASE I.D.AGE
i1C�"f) li
OBJECTIVE: That all store Employees follow all laws and the procedures
of this policy related to the sale of tobacco products including :cigarettes ,
smokeless tobacco,loose tobacco,pip tobacco,rolling papers and cigar .
The minimum age to purchase tobacco products is eighteen(I8) years.
It is our responsibility as retailars and neighbors of the community to prevent
the sale of tobacco to any minors including any Employees. who works in the
store. To avoid violation regarding the sale of tobacco products, all Employee
must read ,review ,and understand this policy. Please note that matches and
lighters are to be treated as tobacco products.
PROCEDURES:
I All store Employees and management personnel must ID all customers
who to purchese tobacco products when they appear to be under the age to
be under the age of 30, unless it is a regular customer (at least once per week)
who has provided proof of legal age to each employee.
2 This policy will be reviewed with all new Employee before they can
operate the register and sell tobacco products .
LOTTERY TICKET SALES POLICY
OBJECIVE : To follow all laws and procedures related to the sale of instant
or on-line tickets as outlined below.
PROCEDURES:
I . The minimum age to purchase Lottery tickets is eighteen (18)years of age
2 . All Employees must ask to see proof of age of all customers who ask to
purchase Lottery tickets when they appear to be younger then thirty years age
3 . No Employee may sell Lottery tickets to any customer below the minimum
age .
4 . No Employee may sell Lottery rickets to any customer who fails to
produce a valid indentification when asked.
5 . Acceptable forms of identification for purchasing Lottery are
• valid Massachusetts State driver's License
• valid Massachusetts Registry of Motor Vehicles State Identification
• Valid Passport
• Valid Out of State License
note : customers using an out of sate license must show a 2" d form of id id such
as a credit card social security card, or birth certificate
3 If a customer is asked to produce proof of age ,the date of birth on the
customer's identification must be entered using the age check key on the
register.
4 If no proof of age is required , an assigned date must be entered using the
age check key.
5 No Employee may sell any tobacco to any person including any Employee
of the company who fails to produce proof of age when asked.
6 Acceptable forms of identification for purchasing tobacco are:
a . Valid Massachusetts State Driver's License
b Valid Massachusetts Registry of Motor Vehicles State Identification
c Valid passport
d Military ID (Active Service Only)
e Valid Out Of State License
note : customers using an out of state license must show a 2"d form of id
such as a credit card, social security card ,or birth certificate
7 All Employees will take the Age Restricted Computer Based Training
and pass the test with a score of 100% before the operate the POS system
to make a sale.
I UNDERSTAND that Massachusetts law prohibits the sale of age restricted
products to anyone under the minimum age set by the commonwealth for
these products ( Tobacco : 18 years , Lottery 18years ) I also understand
that if I fail to follow store policy and state law about the sale of age
restricted products to minor I could face disciplinary action up to and
including termination.
In turn the management of agrees to support my judgement when not
making the sae of age restricted products by following store policy and
procedures .
EMPLOYEE SIGNATURE DATE
OWNER SIGNATURE DATE
( This form will be maintained in your personnel files as part of your permanent
employee record) .
It is ill4egal
tai s4all• . •
prcoducts
tco anycona und4er
thie •, - •
a
C'/A rl I IZI ( 'I 1l 1v' 10 0M I<
It is illegal
to sell tobacco
products
to anyone under
the age of 1S
i��r1 n; i_talzi�l.r< tFrc;r>
Every employee at this store has the legal and moral responsibility to control the sale and
distribution of age restricted items to ensure these items do not get to minors!
LEGAL RESPONSIBILITY IS ALWAYS THE STORE PERSONNELS!!
age restricted Products :
PRODUCT LEGAL AGE TO PURCHESE VALID
€,oltcry I ft Sf} or is=:
ID CHECK BUT FIRM NO DEBATES - "IT'S THE LAW!"
Match the ID photo to the person's face .is the person on the ID the person presenting
to you ?
2 . Date of birth. Is the person of legal age to make the item purchase? One you're
presented with an acceptable ID the ACTUAL DOB must be enterd into the register
for all tobacco & alcohol item
3 . Expiration date . An Expiration ID is no longer a VALID ID We only accept Valid ID
4 . Feel the ID for evidence of tampering All ID's must be handled by the employee
ask customer to remove ID FROM WALLET ETC. AT all times. Anything less is
unacceptable .
Out of state ID's require a 2"d form of identification e.g. credit card
6 . If still unsure if the ID is valid, ask the customer to verify some ID information
his/her date of birth spelling of the last name ,city/town are good examples.
7 . THIRD PARTY SALES: When 2 or more people are part of the purchase of an age-
resricted products all must pass age verification with valid ids If not' NO SALE!!
It is illegal
to sell tobacco
products
to anyone under
the age of 18
FAMILY FOOD MART
4 1sAST ST
MANSFIELD MA-02048
Employee Tobacco Training Program
1),Include Tobacco Product sales Policy in a comprehensive Policy &
Procedures Manual for all Age -Restricted Product Sales. This manual
will be presented by management to all new & existing employees for
their review and signature.
2). Generating an " ID Quick Reference Guide" to be posted at each
register to assist employees in adhering to ID Policy & Procedures
3). Continuous Reinforcement of the Importance of Responsible
Selling Of Age -Restricted Products Offered at the Store.
Tobacco and Lottery sales account for 51 Out Of Every
60 Dollar Handled By Family Food Mart's Employees.
Emphasis On the Importance of Community Responsibility,in
Addition to Legal Responsibility , For This Store To Control
the Sale and Distribution of Age -restricted Items To Ensure
These Items Do Not Get Sold To Minors.
Continuous Reinforcement Will Include Individual Counseling
Sessions With All Employees Throughout the Calendar Years,
Posting of Signs Stating the Store Responsibility For Both
Employees and Customers, Refreshing All Signs 'Twice a Year.
Family Food Mart Will Do This Training Every 3 Months .
If Any Employees or Relative Sell Cigarette To Minors They
Will Not Get Paid For 2 Weeks And If Employees Still Sell
Tobacco Product To Minors Employee Will Receive Suspension
Letter.
Explore conducting Own Compliance Checks at Store Level
ACiI? tzi? s'I'IZ1C;'1'1,I) I'IZODUC" S N)LIC Y AND PROC EDIT P"S'
FOR
FAMILY FOOD MART MANS1 IF1,I)
Every employee at this store has the legal and moral responsibility to
control the sale and distribution of age -restricted items to ensure these
items do not get sold to minors !
LEGAL RESPONSIBILTY IS ALWAYS THE STORE PERSONNELS 11
AGE-RESRICTED PRODUCTS POLICY
Objective: To be in compliance with all federal and state laws concering
the purchase of age -restricted products.
PROCEDURES:
a) State Law specifically restricts the sale of certain products that this store
to customers that are not of legal age including any Employees of this
store.
b) Penalties for violation these statutes range fro monetary fines for both
the store and the individual to revocation of the license on a temporary
or permanent basis.
c) This store and its Employees must use their utmost diligence and follow
set rules & procedures governing the sale of these items. When in doubt
someone's age, always ask for a valid LD
d) The following items are age -restricted
• All Tobacco Products / Rolling Papers
• All Lottery Products
PRODUCTS LEGAL AGE TO PURCHASE I.D.AGE
Tob"Icco t 8 30 or Less
LoUery 19 30 or less
B'O11/' C'M i'1M1)t)CT SA1,1?S 1'OLIC:Y
OBJECTIVE: That all store Employees follow all laws and the procedures
of this policy related to the sale of tobacco products including :cigarettes ,
smokeless tobacco,loose tobacco,pip tobacco,rolling papers and cigar.
The minimum age to purchase tobacco products is eighteen(18) years.
It is our responsibility as retailars and neighbors of the community to prevent
the sale of tobacco to any minors including any Employees who works in the
store. To avoid violation regarding the sale of tobacco products, all Employee
must read ,review ,and understand this policy. Please note that matches and
lighters are to be treated as tobacco products.
PROCEDURES:
1 All store Employees and management personnel must ID all customers
who to purchese tobacco products when they appear to be under the age to
be under the age of 30, unless it is a regular customer (at least once per week)
who has provided proof of legal age to each employee.
2 This policy will be reviewed with all new Employee before they can
operate the register and sell tobacco products .
3 If a customer is asked to produce proof of age ,the date of birth on the
customer's identification must be entered using the age check key on the
register .
4 If no proof of age is required, an assigned date must be entered using the
age check key.
i No Employee may sell any tobacco to any person including any Employee
of the company who fails to produce proof of age when asked .
6 Acceptable forms of identification for purchasing tobacco are:
a . Valid Massachusetts State Driver's License
b Valid Massachusetts Registry of Motor Vehicles State Identification
c Valid passport
d Military ID (Active Service Only)
e Valid Out Of State License
note : customers using an out of state license must show a 2" " form of id
such as a credit card, social security card, or birth certificate
7 All Employees will take the Age Restricted Computer Based Training
and pass the test with a score of 100% before the operate the POS system
to make a sale.
LOTTERY TICKET SALES POLICY
OBJECIVE : To follow all laws and procedures related to the sale of instant
or on-line tickets as outlined below.
PROCEDURES:
1 . The minimum age to purchase Lottery tickets is eighteen (I8)years of age
2 . All Employees must ask to see proof of age of all customers who ask to
purchase Lottery tickets when they appear to be younger then thirty years age
3 . No Employee may sell Lottery tickets to any customer below the minimum
age .
4 . No Employee may sell Lottery rickets to any customer who fails to
produce a valid indentification when asked.
5 . Acceptable forms of identification for purchasing Lottery are
• valid Massachusetts State driver's License
• valid Massachusetts Registry of Motor Vehicles State Identification
• Valid Passport
• Valid Out of State License
note : customers using an out of sate license must show a 2"form of id id such
as a credit card social security card, or birth certificate
I UNDERSTAND that Massachusetts law prohibits the sale of age restricted
products to anyone under the minimum age set by the commonwealth for
these products ( Tobacco : 18 years , Lottery 18years ) I also understand
that if I fail to follow store policy and state law about the sale of age
restricted products to minor I could face disciplinary action up to and
including termination.
In turn the management of agrees to support my judgement when not
making the sae of age restricted products by following store policy and
procedures.
EMPLOYEE SIGNATURE DATE
OWNER SIGNAATURE ATE
( This form will be maintained in your personnel files as part of your permanent
employee record)
Tobacco Retailer Warning Letters > Citgo 11/7/13
Page 1 of 3
Compliance, Enforcement, and Criminal Investigations
Citgo 11/7113
,art°-t
14
Department of Health and Human Services
1TP/17"FGrel"W40
VIA UPS
Citgo
Attn: Site Manager
4 South Main Street
Mansfield, MA 02048
Public Health Service
Food and Drug Administration
Center for Tobacco Products
9200 Corporate Boulevard
Rockville, MD 20850-3229
November 7 201
Re: FDA Warning Letter Regarding Tobacco Retailer Inspection Violations
Reference Number: 13MA006160
Dear Sir or Madam:
This Warning Letter is notification from the United States Food and Drug Administration (FDA)
advising you that Citgo was observed to be in violation of federal tobacco laws and
regulations. Failure to correct these violations may lead to federal enforcement actions, inciudinc
monetary penalties. Your response is requested in 15 working days.
On September 14, 2013, an Inspector representing the FDA completed an Inspection of the
establishment, located at 4 South Main Street, Mansfield, MA 02048. During this Inspection the
establishment was in violation because you or your employee sold cigarettes to a minor and
failed to check identification to verify purchaser's age.
This Inspection revealed that the establishment sells, distributes, advertises, and/or promotes
cigarettes, cigarette tobacco, and/or smokeless tobacco, which requires that the establishment
and its owners comply with federal laws and regulations governing such practices. The violations
observed during the.September 14, 2013, Inspection include the following:
1. A minor was able to buy Marlboro cigarettes on September 14, 2013, at approximately
11:20 AM in the establishment.
A retailer must NOT sell cigarettes, cigarette tobacco, and/or smokeless tobacco to
person younger than 18 years of age. Doing so violates 21 C.F.R. § 1140.14(a).
2. No one in the establishment checked the minor's identification before the sale of
Marlboro cigarettes on September 14, 2013, at approximately 11:20 AM.
A retailer MUST check a photographic Identification that includes a date of birth for any
person under the age of 27 who attempts to purchase cigarettes, cigarette tobacco, and/oi
smokeless tobacco. Failure to do so violates 21 C.F.R. § 1140.14(b)(1).
http://www.fda.gov/ICECl/EnforcementActions/WarningLetters/toba... 1 /29/2014
Tobacco Retailer Warning Letters > Citgo 11/7/13 Page 2 of 3
The listed violations cause your cigarettes to be "misbranded" under 903 of the FD&C Act (21
U.S.C. § 387c).
You should immediately correct the violations listed above. Failure to correct the violations may
result In FDA taking regulatory action without further notice. These actions may include, but are
not limited to, civil money penalty, no -tobacco -sale order, seizure, and/or Injunction.
The violations indicated in this letter may not be a complete list of violations at the
establishment. The establishment must comply with all the applicable laws and regulations. For
more information on these requirements, helpful resources for retailers, a database of
inspections, and free Break the Chain of Tobacco Addiction materials, visit our website at
http://www.fda.gov/TobaccoProducts'
You have 15 working days from the date you receive this letter to respond. In your response,
explain your plan for correcting the listed violations and preventing future violations. Include a
telephone number and address. Note your reference number of 13MA006160 in your response
and mail it to:
SP-WL Response
FDA Center for Tobacco Products
9200 Corporate Boulevard
c/o Document Control Center
Rockville, Maryland 20850
If you have any questions, contact Steven Singhaus at (301) 796-6829 or via email at
Steven.Singhaus@fda.hhs.gov. Have your reference number ready when you call and Include it
with any email communications.
Sincerely,
/s/
Ann Simoneau, J.D.
Director
Office of Compliance and Enforcement
Center for Tobacco Products
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Tobacco Retailer Warning Letters > Dubs's Discount Liquors 11/7/13 Page 1 of 3
Homelnspections, Compliance, Enforcement, and Criminal InvestigationsEnforcement ActionsWarnine
Letters
nspections, Compliance, Enforcement, and Criminal Investigations
Dubs's Discount Liquors 11/7/13
Department of Health and Human Services
WARNING LETTER
November 7, 2013
VIA UPS
Dubs's Discount Liquors
Attn: Site Manager
30 Chauncy Street
Mansfield, MA 02048
Public Health Service
Food and Drug Administration
Center for Tobacco Products
9200 Corporate Boulevard
Rockville, MD 20850-3229
Re: FDA Warning Letter Regarding Tobacco Retailer Inspection Violations
Reference Number: 13MA006154
Dear Sir or Madam:
This Warning Letter is notification from the United States Food and Drug Administration (FDA)
advising you that Dubs's Discount Liquors was observed to be in violation of federal tobacco law:
and regulations. Failure to correct these violations may lead to federal enforcement actions,
Including monetary penalties. Your response is requested in 15 working days.
On September 14, 2013, an Inspector representing the FDA completed an inspection of the
establishment, located at 30 Chauncy Street, Mansfield, MA 02048. During this Inspection the
establishment was in violation because you or your employee sold cigarettes to a minor and
failed to check identification to verify purchaser's age.
This Inspection revealed that the establishment sells, distributes, advertises, and/or promotes
cigarettes, cigarette tobacco, and/or smokeless tobacco, which requires that the establishment
and its owners comply with federal laws and regulations governing such practices. The vlolatlons
observed during the September 14, 2013,inspection include the following:
1. A minor was able to buy Marlboro cigarettes on September 14, 2013, at approximately
12:05 PM in the establishment.
A retailer must NOT sell cigarettes, cigarette tobacco, and/or smokeless tobacco to a
person younger than 18 years of age. Doing so violates 21 C.F.R. § 1140.14(a).
2. No one in the establishment checked the minor's Identification before the sale of
Marlboro cigarettes on September 14, 2013, at approximately 12:05 PM.
A retailer MUST check a photographic identification that Includes a date of birth for any
person under the age of 27 who attempts to purchase cigarettes, cigarette tobacco, and/oi
smokeless tobacco. Failure to do so violates 21 C.F.R. § 1140.14(b)(1).
http://www.fda.gov/ICECl/EnforcementActions/WamingLetters/toba... 1 /29/2014
Tobacco Retailer Warning Letters > Dubs's Discount Liquors 11/7/13 Page 2 of 3
The listed violations cause your cigarettes to be "misbranded" under 903 of the FD&C Act (21
U.S.C. § 387c).
You should immediately correct the violations listed above. Failure to correct the violations may
result in FDA taking regulatory action without further notice. These actions may include, but are
not limited to, civil money penalty, no -tobacco -sale order, seizure, and/or injunction.
The violations indicated in this letter may not be a complete list of violations at the
establishment. The establishment must comply with all the applicable laws and regulations. For
more information on these requirements, helpful resources for retailers, a database of
inspections, and free Break the Chain of Tobacco Addiction materials, visit our website at
http://www.fda.gov/TobaccoProducts'.
You have 15 working days from the date you receive this letter to respond. In your response,
explain your plan for correcting the listed violations and preventing future violations. Include a
telephone number and address. Note your reference number of 13MA006154 in your response
and mail it to:
SP-WL Response
FDA Center for Tobacco Products
9200 Corporate Boulevard
c/o Document Control Center
Rockville, Maryland 20850
If you have any questions, contact Aaron Weisbuch at (301) 796-9362 or via email at
Aaron.Welsbuch@fda.hhs.gov. Have your reference number ready when you call and include it
with any email communications.
Sincerely,
/s/
Ann Simoneau, J.D.
Director
Office of Compliance and Enforcement
Center for Tobacco Products
Return to Tobacco Retailer Warning Letters Main Pagel
Page Last Updated: 11/21/2013
Note: If you need help accessing Information in different file formats, see Instructions for
Downloading Viewers and Players.
Access! biIItyContact FDACareersFDA BasicsFOIANo Fear ActSite MapTransparencyWebsite
Policies
U.S. Food and Drug Administration
10903 New Hampshire Avenue
Silver Spring, MD 20993
Ph. 1-888-INFO-FDA (1-888-463-6332)
Email FDA
For GovernmentFor Press
http://www. fda. gov/ICECl/EnforcementActions/WamingLetters/toba... 1 /29/2014