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02-599r. � t ;�� �i�� � � � S � i,ee ;� Presented By Referred To RESOLUTION CITY OF SAINT PAUL, MINNESOTA Council File # . � � � 599 � ♦ Green Sheet # �O� ��] -- f 19 Committee= Date WHEREAS, on June 6, 2001 the licensee, Snyder Drug Store, Inc. d/b/a Snyder Bros Drugs, Inc. #5073 (License ID No. 0014805), located at 1620 White Bear AvenueNorth in Saint Paul, failed a second cigazette compliance check conducted at the licensed establishment, a Notice of Violation was sent to the licensee on June 13, 2001, but the licensee did not respond; and WHEREAS, on March 12, 2002 the licensee failed a third cigarette compliance check conducted at the licensed establishment. On April 1, 2002 a Notice of Violation was sent to the licensee. On April 8, 2002 the store manager contacted the Saint Paul City Attorneys Office and requested information on the history of the violations, but no fiu contact was made by the licensee; and WHEREAS, on May 9, 2002, the Saint Paul City Attorney's Office sent a letter to the licensee outlining the recommendation of a combined penalty for the two violations, which was a $400.00 fine for the second violation and a thirty day suspension of the cigarette license for the third violation; and WHEREAS, as of June 17, 2002, the licensee has not responded to either contest the violations or request a hearing before the Saint Paul City Council; now therefore, be it RESOLVED, that the Licensee, SnyderDrug Store, Inc. d/b/a SnyderBros Drugs, Inc. #5073 (License ID No. 0014805), located at 1620 White Bear Avenue North in Saint Paul is hereby ordered w pay a fine of $400.00 for the June 6, 2001 violation of the sale of tobacco or tobacco products to a minor. Said fine shall be paid to the Office of License, Inspections and Environmental Protection within thirty (30) days of the adoption of this resolution by the Council and signature by the Mayor. FLTRTI�,R RESOLUED, that the Cigarette/Tobacco License held by Snyder Drug Store, Inc. d/b/a Snyder Bros Drugs, Inc. #5073 (License ID No. 0014805), located at 1620 White Bear Avenue North in Saint Paul, is hereby suspended for a period of thirty days for the March 12, 2002 violation of sale of tobacco or tobacco products to a minor. The suspension will begin at 12:01 a.m. on Wednesday, July 24, 2002, and continue untii 11:59 pm. on Thursday, August 22, 2002. � 2 3 4 5 6 7 8 9 al�s9� This resolution and the action of the Council in this matter are based upon the facts contained in the June 13, 2001 and April 1, 2002 Notice of Violarion letters to the licensee and the June 6, 2001 and March 12, 2002 Tobacco Compliance Check Purchase Forms. The licensee did not contest the facts of either violation. L.'����iV�� Requested by Department of: BY: �,�.��, �- �� Adopted by Council: Date�'3 a.o a Adoption Certified by Council Se etary By: Mayor: Date 4�� Form Approved by City By: Mayor for S�ni�s3.qn to �/�i � /!��-�_,/��-- DEPARTMENT/OFFICE/COUIYCII.: DATE INITIATED GREEN SHEET NO.' ZOOZS7 �^ , LIEP June 20, 2002 ' �3 • • CONTACT PERSON & PHONE: IlVI'i7wi/nATE INITIAIIDATE VirginiaPalmer(266-8710) � �P,�IM�T Dm � G- _cincour�cn. �- M[JST BE ON COUNCII, AGENDA BY (DATE) ` �Ni SMBER � CITY ATIORNEY�� _ CITY CLERK FINANCIAI. SERV DIIL FINANCIAL SERV/ACCTG July 3, 2002 (consent) gpg MAYOR (OR ASST.) _ CNII, SERVICE COMMISSION ROUTING ORDER TOTAL # OF SIGNAI'IJRE PAGES _(CLIP ALL LOCATIONS FOR SIGNATURE) ncnoN �QueszEn: Adverse action against the Cigarette/Tobacco license held by Snyder Drug Store, Inc. d/b/a Snyder Bros Drugs, Inc. #5073, located at 1620 White Bear Avenue North RECOMMENDA110NS: Approve (A) or Reject (R) PERSONAI, SERVICE CONTRACTS MUST P,IYSWF.R THE FOLLOWING QUESTIONS: PLANNING COMMISSION 1. Has this person/firm ever worked under a contract for this depariment? CID COMMITI'EE Yes No CNII. SERVICE COMMISSION 2. Has this person/fiim ever been a ciTy employee? Yes No 3. Does this p�son/fivn possess a skill not normally possessed by any curtent c�Ty employee? Yes No . Explain all yes aoswers on separate sheet and attach to green sheet � INITIATING PROBLEM, ISSUE, OPPOR'1'UNITY (Who, Whay When, Where, Why): Snyder Drug Store, Inc. d/b/a Snyder Bros Drugs, Inc. #5073, failed June 6, 2001 and March 12, 2002 cigarette ' compliance checks. - ADVANTAGESIFAPPROVED. Council action necessary to enforce penalty for license violation. ���� �¢�� ' ���"� � � �L-��� , DISADVANTAGESIFAPPROVED: None. . DISADVANTAGES IF NOT APPROVED: No penalty will be imposed for license violation. � TOTAL AMOUNT OF TRANSACTION: $ COST/REVENUE BUDGETED: FUNDING SOURCE: ACTIVITY NUMBER: FINANCIAL INFORMATION: (EXPLAI� I\USERS�PAiSGBORMgeasheec - cigarette cortql H wpd OFFICE OF THE CITY ATTORNEY MartuelJ. Cervan[es, CityAttomey CITY OF SAINT PAUL Randy C. Ke/ly, Mnyor CivilDivision a00 Ciry Ha7l 1 i West Kellogg BIrA. Saint Paul, Minrtesota 5510? o�-sy9 Telephone: 651266-8710 Facsimile: 651298-5619 June 18, 2002 NOTICE OF COUNCIL MEETING Owner/Manager Snyder Bros Drugs, Inc. #5073 1620 White Bear Avenue North Saint Paul, Minnesota 55106 RE: Cigarette/Tobacco License held by Snyder Drug Store, Inc. d/b/a Snyder Bros Dru�s, Inc. #5073 for the premises at 1620 White Bear Avenue North in Saint Paul License ID #: 0014805 Dear Sir/Madam: Please take notice that this matter has been set on the Consent Agenda for the Council meeting scheduled for 3:30 p.m., Wednesday, July 3, 2002 in the City Council Chambers, Third Floor, Saint Paul City Hall and Ramsey County Courthouse. Enclosed are copies of the proposed resolution and other documents which will be presented to the City Council for their consideration. This is an uncontested matter in that the facts contained in the rivo Notice of Violation letters concerning the unlawful sale of cigarettes have not been disputed. As indicated, this matter has been placed on the consent agenda portion of the City Council meeting during which no public discussion is allowed. The recommendation of the license office will be for a 30-day suspension of your Cigazette/Tobacco license and a $400.00 fine. If you have any questions, please call me at 266-8710. Very truly yours, �'/ `� ��., �� Virginia D. Palmer Assistant City Attorney cc: Nancy Anderson, Assistant Council Secretary Christine Rozek, LIEP Chuck Repke, Community Organizer, Dist. 2 Community Council, 1961 Shenvood Ave., St. Paul, MN 55119-3230 AA-ADA-EEO Employer o�-S99 UNCONTESTED LICENSE MATTER Licensee Name: Address: Council Hearing Date: Snyder Drug Store, Inc. d/b/a Snyder Bros Durgs, Inc. #5073 1620 White Bear Avenue North Wednesday, July 3, 2002 Violation: Sale of Cigarettes to a Minor Minn. Stat. § 609.685 St. Paul Legislative Code § 324.07 Date of Violations: Place: Presumptive Penaity: March 12, 2002 and June 6, 2002 Licensed Premises $400.00 fine (second violation) and 30-Day Suspension of Cigarette/Tobacco License (3r violation) Recommendation of Assistant City Attorney on behalf of client, Office of License, Inspections and Environmental Protection: 30-Day suspension of Cigarette/Tobacco license and $400.00 fine Attachments: 1. Proposed resolution 2. May 9, 2002 letter from Virginia Palmer to licensee 3. April 1, 2002 Notice of Violation letter AA-ADA-EEO Employer � �-�99 4. March 12, 2002 Tobacco Compliance Check Purchase Form 5. June 13, 2001 Notice of Violation 6. June 6, 2001 Tobacco Compliance Check Purchase Form 7. License Information Report 8. License information AA-ADA-EEO Employer OFFIC" 7F THE CITY ATTORNEY Mrsnve� ,erv¢ntu,CiryA(torney OF SAINT PAUL rs . Kel[y, Mayor aWr Civi( Division 400 Ciry Nall I S Wut Ke[logg B7vd Snint Paul, Minnuo�a 55102 a a--s97 Telephone: 651266-8710 Facsimile: 65/ 298-5619 May 9, 2002 Owner/Manager Snyder Drug Store, Inc. 1620 White Bear Avenue North Saint Paul, MN 55106 RE: Cigarette/Tobacco License held by Snyder Drug Store, Inc., d/b/a Snyder Bros. Drugs, Inc. #73, for the premises located at 1620 White Bear Avenue North in Saint Paul License ID: 14805 Dear Sir/Madam: On April 1, 2002 you were sent a Notice of Violation advising you that there had been a tobacco complia� check done at your store on March 12, 2002 which you failed. The Notice stated that this was a thrid Violation and that the recommendation was for a 30-day suspension of your license, together with a�SfSO penalty due to the fact that the three violations occurred in a very short period of time. In reviewing the licensing records, however, it appears that you never responded to the second Notice of Violation letter dated June 13, 2001, a copy of which has been enclosed. Our records show that the fine was never paid. Unless you have documentation that the fine has been paid on the June 6, 20Q1 violation or that you requested a hearing on the allegations, this matter still needs to be addressed. Because the second violation was never admitted or acted upon the current violation can be combined with the second violation and both matters heard before the Council as to the appropriate penalty. There will be an amended recommendation for the rivo violations, which will be for a thirty day suspension and a$400 fine. These represent the combined presumptive penalties for a second and third violation. If you have any questions regarding this matter please feel free to contact me at (651) 266-8710. Sincerely, � � � "�-'C N�.fi� Virginia . Palmer Assistant City Attomey cc: Christine Rozek, Deputy Director of LIEP AA-ADA-EEO Employer OFFIC' ° THE CITY ATTORNEY Manuel J. a.mnntes, City Attorney CITY OF SAINT PAUL avrror,rsro� Randy C. Kel[y, Mnyor 400 Ciq� Hall /5 West Kellogg Blvd. Snirtt Paid, Mirtrtuom SSIO? i April 1, 2002 NOTICE OF VIOLATION Owner/Manager Snyder Bros Dru�s, Inc. #5073 1620 White Bear Avenue North Saint Paul, Minnesota 55106 O S99 Telep/rone: 65! 166-87l0 Fncsiniile: 65f 298-5619 RE: Cigarette/Tobacco License held by Snyder Dru� Store, Inc. d/b/a Snyder Bros Dru�s, Inc. #5073 for the premises at 1620 White Bear Avenue North in Saint Paul License ID #: 0014805 Dear Sir/Madam: The Office of License, Inspections and Environmental Protection has recommended adverse action a�ainst the Cigarette/Tobacco License held by Snyder Dru� Store, Inc. d/b/a Snyder Bros Drugs, Inc. #5073 for the premises at 1620 White Bear Avenue North in Saint Paul. The basis for the recommendation is as follows: On March 12, 2002, a tobacco compliance check was conducted at Snyder Bros Drugs, Inc. #5073 located at 1620 White Bear Avenue North in Saint Paul. A fifteen year old female entered the store and asked to buy cigarettes. She was asked to show her identification, and did so. It correctly stated her date of birth. The clerk nevertheless sold her a package of Salem 100's cigarettes. Sale of tobacco to an underage person is a violation of Minn. Stat. §609.685 and Saint Paul Legislative Code §324.07. Althou�h the presumptive penalty for a third violation is a 30 day suspension of your cigarette license, the licensing office will be recommendin� an additional penalty of a$500 fine, based upon the short period of time in which the violations have occurred. At this time you have three options on ho�v to proceed: 1. Ifyou do not dispute the above facts and do not wish to have a public hearing, you «�ill need to pay the recommended fine for this violation. If this is your choice, you should AA-ADA-EEO Employer Page 2 Snyder Bros Drugs, Inc, #5073 Apri11,2002 O�.-S91 make payment directly to the Office of License, Inspections and Environmental Protection, Room 300 Lowry Professional Building, 350 Saint Peter Street, Saint Paul, Minnesota 55102. The letter should be directed to Ms. Christine Rozek. Payment of the fine will be considered to be a waiver of the hearing to which you are entitled and agreement to the suspension of your Cigarette/Tobacco license. The licensing office will then notify you of the dates for the license suspension durin� which you �vill not be allowed to sell tobacco products. A self-addressed envelope is enclosed if this is your choice. 2. Alternatively, if you do not dispute the above facts, but wish to have a public hearing before the Saint Paul City Council, you will need to send me a letter with a statement admitting the violation and requesting a public hearing. We will need to receive your letter by Thursday, April 11, 2002. The matter will then be scheduled before the City Council for a public hearing to determine what penalty, iF any, to impose. You will have an opportunity to appear before the Council and make a statement on your own behalf. 3. If you do dispute the above facts, a hearing will be scheduled before an Administrative Law Judge. At that hearing both you and the City will be able to appear and present witnesses, evidence and cross-examine the other's witnesses. The St. Paul City Council will ultimately decide the case. If this is your choice, please advise my legal assistant, Peter Pangbom, and we will take the necessary steps to schedule the administrative hearing. He can be reached at 266-8710. If we have not heard from you by Thursday, Aprii 11, 2002, we will assume that you do not contest the facts and will schedule this matter for the St. Paul City Councii and have it placed on the Consent Agenda during which no public discussion is allowed and the recommended penalty will be imposed. Please be advised that the clerk who was identified as havin� made the sale on this date is also being charged an administrative penalty pursuant to Minn. Stat. §461.12, subd. 3. This is a separate action from this license matter. If you have any questions, please feel free to contact me at (651) 266-8710. Sincerely, /� �.KG2� ��� �11G-� Virginia D. Palmer Assistant City Attomey cc: Christine Rozek, Deputy Director of LIEP Chuck Repke, Community Or�anizer, Dist. 2 Community Council, 1961 Sher:;ood Ave., St. Paul, MN 5 5 1 1 9-3230 A.4-ADA-EEO Employcr License Group r,omments Text Licensee: SYNDER DRUG STORE (NC �BA� SNYDER BROS DRUGS INC #5073 License #: 0074805 03l22I2002 O�-Sq9 03f25/2002 To CAO for adverse action. CAR 03/12/2002 Failed tobacco compliance check Clerk was Breann Buege. Third violation within 18 months. Presumptive penalty is 30 day suspension. 11EP recommends a 55�0 fine as well because all 3 sales took place within '12 months. CAR 09/'18/2001 Passed Tobacco Compliance Check. SS 07/312001 Letter from CAO indicating that fine is unpaid and must be submitted by 08/OS/200�. Letter was sent in error - fine has been paid. CAR �7/23l20ot $260 rcvd in payment for cig fine_ caa 07/'17l2001 $50 rcvd in payment for cig fine. caa 07/03/2001 Sent fine letter ($200 due 7/20/O7). LAB 061202001 CF01-620 orderd to pay fine of 5200 for vioiation of sale of tobacco to a minor. qa 06/062001 Notice of Violation from CAO for sale of tobacco to a minor. Given til O6/25/2001 to respond. AG/CAR 06l04/2001 Notice of Counci! Meeting from CAO for 04/03Y2001 compliance failure. Placed for consent on 06l20/2001 council agenda. CAR 06/06/2001 Failed tobacco compliance check. Clerk was Abbie Marie lange, 2287 E 13th, 55109 .Second violation, 5400 matrix penalty. CAR OS/07/2001 Paid $50 clerk fine for 04/03/2001 violation. CAR 04/18/2007 Notice of Violation from CAO. For 04/032001 sale of tobacco to underege person after showing wrred identification. Have three options and expect letter of desicion by 04/30/2001- CAR/AG 04/03/2001 Failed tobacco compliance check. First failure, $200 matri� penalty. Clerk was Krista Dufresne, 2178 Clear, 55119. CAR 08/082000 Passed tobacco compliance check. SS 1/1/93 Florist & Hardware licenses repealed 02/23/98 Pet shop removed at owners' request. CAR 04/28/99 passed cig compliance check - letter sent 05l04/99 SS 0 �-Sq� STATE OF MINNESOTA ) ) ss. COUNTY OF RAMSEY ) AFFIDAVIT OF SERVICE BY MAIL JOANNE G. CLEMENTS, being first duly sworn, deposes and says that on April 1, 2002, she served the attached NOTICE OF VIOLATION on the following named person by placing a true and correct copy thereof in an envelope addressed as follows: Owner/Manager Snyder Bros. Inc. #5073 1620 White Bear Avenue St. Paul, MN. 55106 (which is the last known address of said person) depositing the same, with postage prepaid, in the t3ni States mails at St. Paul, Minnesota. / \ � _ � G. Subscribed and sworn to before me this 1st day o�April, 2002. PETER P. PANGBORN NOTARY PUSLIC - P�I�iY`cS0?A MY COMMlSSIO� EXPffr?F5 JAN. 31, ?007 Notary OFFICE OF LICENSE, INSPECTIONS AND ENVIItONMENi'AL PROTECIfON O i �S, � Roga G Curlr.r, Directar s��Ht PAU L � AAAl1 CTTY OF SAINT PAUL R¢ndy C. Kelly, Mayor Tobacco Compliance Check Pnrchase Form Case # i SYNDER DRUG STORE INC SNYDER BROS DRUGS INC #73 1620 WHITE BEP,R AVE N ST PAUL, MN 55106-1608 Adult � � � Business Type: � Convenience � Convenience / Gas � Cras �Drug Store / Phazmacy � Tobacco / Smoke Shop � Supermarket / Grocery � General Mezchant � Liquor Store / Baz Restaurant � Other (privace club, bowiing, ecc.) Date: � � � � � / � � TIIIIO: � . � a.m. / .n 1 M M D D Y Y Was purchase attempted? If NO, check reason: �Yes � No �Does not sell tobacco � Unsatisfactory/unsafe conditions � Out of business � Otha � Afrer business hours � Not applicable Buyer ��"� Use 3 initials Aee Sea � � I� Wa sale made? Was age � � or No Yes oz No l.� Type of purcfiase: Self Service �Clerk assisted _ Vending machine - Unlocked Location of machine __ Vending machine - Locked Locauon of machine Clerk Information: �Female � Male Use 3 initials For Officc Use Onty � Compiiance CheckLD.# " ausincss ].D. n rro ord;n�,� Did adult or o�cer vie transaction? Yes or No Wa�ID requested? W��D shown? es} ar No `��or No Typ f product: t Amount spent: $ 0 �. �� _Cigazettes ��vvx_ l(}!l S Smokeless _Other (cigazette papers, lighter, Approsimate Age: �Unda 18 / CivH Prnalty S Licenstt: Civil Prnalty 5 For O�ce Use Ooly Criminat Penatry S Suspuvsion:__IO days or less ,_32 days to t ycaz AcYUal age if kaowu_ - �� 18 and O _l l to 31 days _Ova 1 yeaz IAWRYPAOF£SSIONALBUIISANG Tvlryhonc 651-266-9090 350StPetuSlreet,Suite300 F¢oimile: 651d6G9124 Saint Pmel, M'utnesar¢ 55102-1 SIO Web: wvrvi.c'tstpmti.mn,ys/(iep Rcvisc 17l142p01 �� -s91 k �� J� Name of Date of Birth Address Driver's License # or State I. 5��6�--� � ` � �t \�No �� �d�"' �`�' �`,,,_-� �� �� ��,e�, � a �� �= I U'+`�-' ti �� 1 OFFICE nF THE CITY ATTORNEY Qnytors b Sirtson, Jr., Ciry Altorney� CITY OF SAINT PAUL Norm Ca[einnn, Afnyor cma or,as;ort 400 Ciry Hnl1 15 Wesl Kelfogg Blvd. Snint Pnuf, A�linnuota S.i102 a � -S9'( Tefephone: 651266-871 D F�<sin+ife: 65! 298-5619 June 13, 2001 NOTICE OF VIOLATION Owner/Manager Snyder Bros Dru�s 1620 White Bear Avenue North Saint Paul, Minnesota 55106-1608 RE: Cigarette/Tobacco License held by Snyder Dru� Store, Inc., d/b/a Snyder Bros. Drugs, Inc. #73 for the premises located at 1620 White Bear Avenue North in Saint Paul License ID #: 14805 Dear Sir/Nladam: The Office of License Tnspections and Environmental Protection has recommended adverse action against the cigarette/tobacco license held by Snyder Drug Store, Inc., d/b/a Snyder Bros. Drugs, Inc. #73 for the premises located at 1620 White Bear Avenue North in Saint Paul. The basis for the recommendation is as follows: On June 6, 2001, a tobacco compiiance check was conducted at Snyder Bros. Drugs located at 1620 White Bear Avenue North in Saint Paul. A sixteen year old female entered the drug store and asked to buy cigarettes. She tivas asked to show her identification, and did so. It correctly stated her date of birth. The clerk nevertheless sold her a package of Ne�vport cigarettes. Sale of tobacco to an underage person is a violation of Minn. Stat. §609.85 and Saint Paul Legislative Code §324.07 Since this is a second violation, the licensing office will recommend a$400.00 fine. At this time you have three options on how to proceed: 1. If you do not dispute the above facts and do not �vish to have a public hearing, you will need to pay the recommended fine for this violation. If this is your choice, you should make payment directly to the Office of License, Inspections and Environmental Page 2 Snyder Bros Drugs June 13, 2001 � o� •.t94 Protection, Room 300 Lo�vry Professional Building, 350 Saint Peter Street, Saint Paul, Minnesota 55102. The letter should be directed to Ms. Christine Rozek. Payment of the fine will be considered to be a waiver of the hearing to �vhich you are entitled. 2. Altematively, if you do not dispute the above facts, but wish to have a public hearing before the Saint Paul City Council, you will need to send me a letter with a statement admitting the violation and requesting a public hearin�. We will need to receive your letter by Monday, June 25, 2001. The matter �vill then be scheduled before the City Council for a public hearing to determine what penalty, if any, to impose. You will have an opportunity to appear before the Council and make a statement on your own behalf. 3. If you do dispute the above facts, a hearin� will be scheduled before an Administrative Law Judge. At that hearing both you and the City will be able to appear and present witnesses, evidence and cross-examine the other's witnesses. The St. Paul City Council will ultimately decide the case. If this is your choice, please advise my legal assistant, Peter Pangbom, and we will take the necessary steps to schedule the administrative hearing. He can be reached at 266-8710. If we have not heard from you by Monday, June 25, 2001, we will assume that you do not contest the facts and will schedule this matter for the St. Paul City Council and have it placed on the Consent Agenda during which no public discussion is allowed and the recommended penalty will be imposed. Please be advised that the clerk who was identified as having made the sale on this date is also being charged an administrative penalty pursuant to Minn. Stat. §461.12, subd. 3. This is a separate action from this license matter. If you have any questions, please feel free to contact me at (651) 266-8710. Sincerely, `�/ 1 �,/�..�� � (�� Virginia D. Palmer Assistant City Attorney cc: Christine Rozek, Deputy Director of LIEP Chuck Repke, Community Organizer, Dist. 2 Community Council, 1961 Shen��ood Ave., St. Paul, MN 55 1 1 9-3230 OZ-S9y STATE OF MINNESOTA ) ) ss. COUNTY OF RAMSEY ) AFFIDAVIT OF SERVICE BY MAIL JOANNE G. CLII�NTS, being first duly sworn, deposes and says that on June 14, 2001, she served the attached NOTICE OF VIOLATION on the following named person by placing a true and correct copy thereof in an envelope addressed as follows: Owner/Manager Snyder Bros. Drugs 1620 White Bear Avenue No. Saint Paul, Minnesota 55106 (which is tYie last known address of said person) and depositing the same, with postage prepaid, in the Unit�1-S.�ates mails at St. Pau1, Minnesota. � � � JOANNE G\ CLEMENTS Subscribed and sworn to before me this 14th day of June, 2001._ Notary Public .�� rarnRrwsuc M��sora MY CAMMISSION EXPIRES JAN. 31. 2Cpg CTfY OF SAINT PAUL Narm Coleman, Mayor OFFICE OF LICE*ISE, INSPECTIONS AND E?�VIRONMENI'AL PROTEC2TON Oa..f9� Rogu Cwxis, Dlrector LOWAYPROFESSION.4LBUbDING Telephone: 65Id66-9090 350 St Peta Strerl, Suite 300 FacsimBe: 65I-266-9124 Saint Paul, �n�sot¢ 55102-lSIO Web: www.cisipm�Lmn.us(fiep Tobacco Compliance Check Purchase Form Case # ...� _��,� °�� .� .��,� :�� SNYDER BROS DRUGS WC #73 ��-���L ���.�.� -�,,,:;_ 1620 WHITE BEAR AVE N `g'us�s�`�'-� � � �°�= �- �- �-�� ST PAUL, MN 55106-1608 ��'�` � "� ��� ��#�' �asr�am� �.,�.� ��-�.� LicenseType: License# �:,� �? _��;� ���?_.- � _.�z.. �.�x = Cigarettelfobacco 00'14805 BllS1IICSS T�C: � Convenience � Convenience / Cras � Gas �Drug Stoie / Pl�armacy � Tobacco / Smoke Shop � Supem�arket / Grocery � General Merchant �Liquor Store / Baz Restaurant � Other (privam club, bowling, ecc.) Date: � I � I � Time: � . � ` a.m.� M M D D Y Y Was p rchase attempted? If NO, check reason: �F'Yes �No �Does not sell tobacco �Unsatisfactory/unsafe condirions � Out of busmess � Other - �After business hoius �Not applicable Buyer W� �� Age Sea Adult � Q� Did adult or officer view transaction? Use 3 initiaLc 15 Pr� ale Use 3 initiaLs Yes or � �� � 17 sale made? Was a e as ? W r uested? sfiown? Ye or No Yes or No �r �No Yes or No Typ�e� purchase: Typ� of product�: � Amount spent: $ ��. �� _ Service V Cigarettes �" ��� � `/Clerk assisted Smokeless _V ending maclune - Unlocked _Cigazs Location of machine _Other (cigarette papexs, lighter, etc.) _Vending machine - Locked Location of machine Clerk Information: � Female � Male Approaimate Age: der 18 Actual age if known . " ,-..._.. -.� . ,-':.: _ -.. . _. . . _ . . •... ,. .,.. .. � - ' an ' - � =: ; .c . ` Civit$"�tSCS- - - . C�miva�=Ymaity-& - , . 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