HomeMy WebLinkAbout3251 W. 9TH STREET 0 A TF INVOICE DATE DUE DATE INVOICE # TOTAL DUE
^ . £ E�q F i (
01/21/2026 02/25/2026 2026-00000303 $80.00
ririr���� cdic)
O
• •I I I f i iiii i�iiiii�ii i .
Customer #: 24894 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
BLACK HAWK GRUNDY HEALTH 715 Mulberry St
3251 W 9TH ST WA TERLOO, IA 50703
WATERLOO, IA 50702
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL FIRE INSPECTION - 3251 W 9TH ST - 01/15/2026 FOR BILLING INQUIRY: (319)291-4323
Description Total Price
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE # CHARGES
24894 01/21/2026 02/25/2026 2026-00000303 $80.00
Less Prepayment $0.00
Total Due —+ $80.00
City of Waterloo
Failure to pay in full debts listed herein within ninety days of the due date will result in an additional twenty-five percent
late fee applied to any outstanding balance. The delinquent account will be forwarded to Municipal Collections of
America for further collection efforts. Debts shall also be subject to collection through the Iowa Department of
Administrative Services Offset Program if not paid in full within ninety days.
yItfggi
Waterloo Fire Rescue V
dicInspection Report 425 E.3rd Street
Black Hawk Grundy Mental Health-3251 W 9th ST,BLDG 3251 W 9th St,Waterloo IA
50702
INSPECTION DETAILS
Inspection Date Inspection Type Inspection Number
0111512026 Annual Inspection(1Yr) 15968
Lead Inspector Shift Station Unit
JEREMIAH VANDYKE NIA N/A NIA
Other Inspectors
NIA
SUMMARY OF INSPECTION
044 O1 028
Passed codes Failed codes NIA codes
NEXT STEPS
Please direct questions about your Inspection to: Reinspection Date
JEREMIAH VANDYKE 02114/2026
jeremiah.vandyke@waterloo-ia.org
GENERAL NOTES
JEREMIAH VANDYKE-01/15/2026 @ 16:32
121112025 S-(Annual)Fire Alarm HAWKEYE ALARM Reviewed Compliant
JEREMIAH VANDYKE•0111512026 @ 16:32
Fire extinguishers serviced by Midwest alarm December 2025.
JEREMIAH VANDYKE-0111512026 @ 16:38
Re-inspection dates are automatically generated 30 days out from the initial inspection.Normal operating hours for inspections&re-inspections are
Monday-Friday,8:00 am.-5:00 p.m.If the automatically generated re-inspection date lands on a weekend,the re-inspection will typically be performed
the following Monday or Tuesday.If all corrections are made before the 30 days,you can call to setup an earlier re-inspection."."Re inspection fees
may be assessed for subsequent re•inspections.Re-inspection fees start at$100,then$150,and$200 for all subsequent re-inspections.-
JEREMIAH VANDYKE-0111512026 @ 16:38
Lt.Van Dyke-jeremiah.vandyke@waterloo-ia.org-Work:319-291-4460-Cell:319-883-1615
JEREMIAH VANDYKE-01/1512 0 2 6 @ 16:38
Inspection Fee=$80.00(To be mailed out by City via snail mail.)
SIGNATURES
Contact signature Inspector signature
No signature
Report completed post inspection
Thomas C.Eachus Date: JEREMIAH VANDYKE 01115/2026
GENERATED ON 1/15/26,4:40 PM 1 OF 3
CHECKLISTS
Emergency Equipment
Sti,._ Code Description
Fail 1203.2.15•Means of egress illumination.
Emergency power shall be provided for means of egress Location:1.Egress light#29 North west stairway 2.#27 near break
illumination in accordance with Sections 1008.3 and 1104.5.1. room 019.3.Laundry room
Comments:3 egress lights tested and failed.Please contact me after
repaired.
•
GENERATED ON 1/15/26,4:40 PM 2 OF 3
. lY
Po Statement of Fees
FEE
Invoice Date Inspection Fee Date Paid Amount Paid
NIA $80.00
Invoice Number Check Number Transaction Number
NIA NIA N/A
GENERATED ON 1/15/26,4:40 PM 3 OF 3