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INVOICE DATE
DUE DATE
INVOICE #
TOTAL DUE
03/11/2025
04/15/2025
2025-00000297
$100.00
Customer #: 20752
HY-VEE #1
2834 ANSBOROUGH AV
WATERLOO, IA 50701
Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
715 Mulberry St
WATERLOO, IA 50703
Amount Enclosed.
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION - 2834 ANSBOROUGH AVE - 2-11-25
FOR BILLING INQUIRY: (319)291-4323
Description
INSPECTION 20,000
OCCUPANCY FEE
Total Price j
$90.00
$10.00
CUSTOMER #
BILLING DATE
DUE DATE
INVOICE #
CHARGES
20752
03/11/2025
04/15/2025
2025-00000297
$100.00
Less Prepayment
TotalDue —>
City of Waterloo
$0.00
$100.00
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.
WATERLOO FIRE RESCUERe4()
INSPECTION REPORT
HY-VEE, 2834 ANSBOROUGHAVE, BLDG 2834 ANSBOROUGHAVE, WATERLOO IA S070
100
DETAILS
Inspection Date: 02/11/2025 I Inspection Type: Annual Inspection (1 Yj Inspection
Unit: N/A I Lead Inspector: JEFF SIEBEL I Other Inspectors: N/A 1 Fqe: $100.00
VIOLATIONS AND COMPLIANCES
umber: 13791 Shift: N/A i Station: N/A
Showing only violations and images for this inspection. Please reach out to the lead inspector for more details.
Resolved Violations: 0 I Passed Codes: 51 1 Violations: 3 I N/A Codes: 20
STATUS CODE DESCRIPTION
FAIL 1010.2.5 - Bolt locks. Manually operated flush bolts or surface bolts are not permitted. Exceptions:
1.On doors not required for egress in individual dwelling units or sleeping units.
2.Where a pair of doors serves a storage or equipment room, manually operated
edge- or surface -mounted bolts are permitted on the inactive leaf. 3.Where a pair
of doors serves an occupant load of less than 50 persons in a Group B, F or S
occupancy, manually operated edge- or surface -mounted bolts are permitted on
the inactive leaf. The inactive leaf shall not contain doorknobs, panic bars or
similar operating hardware. 4.Where a pair of doors serves a Group B, F or S
occupancy, manually operated edge- or surface -mounted bolts are permitted on
the inactive leaf provided that such inactive leaf is not needed to meet egress
capacity requirements and the building is equipped throughout with an
automatic sprinkler system in accordance with Section 903.3.1.1. The inactive leaf
shall not contain doorknobs, panic bars or similar operating hardware. 5.Where a
pair of doors serves patient care rooms in Group 1-2 occupancies, self -latching
edge- or surface -mounted bolts are permitted on the inactive leaf provided that
the inactive leaf is not needed to meet egress capacity requirements and the
inactive leaf shall not contain doorknobs, panic bars or similar operating
hardware.
Location: Dock Area Exit Door
Original Comment: Immediatly permanently remove slide bolt lock. REPEAT
VIOLATION. Next violation will be an immediate citation.
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STATUS CODE DESCRIPTION
FAIL
5303.5.3 - Securing
compressed gas containers,
cylinders and tanks.
Compressed gas containers, cylinders and tanks shall be secured to prevent
falling caused by contact, vibration or seismic activity. Securing of compressed
gas containers, cylinders and tanks shall be by one of the following methods:
1.Securing containers, cylinders and tanks to a fixed object with one or more
restraints. 2.Securing containers, cylinders and tanks on a cart or other mobile
device designed for the movement of compressed gas containers, cylinders or
tanks. 3. Nesting of compressed gas containers, cylinders and tanks at container
filling or servicing facilities or in sellers' warehouses not open to the public.
Nesting shall be allowed provided that the nested containers, cylinders or tanks,
if dislodged, do not obstruct the required means of egress. 4.Securing of
compressed gas containers, cylinders and tanks to or within a rack, framework,
cabinet or similar assembly designed for such use. Exception: Compressed gas
containers, cylinders and tanks in the process of examination, filling, transport or
servicing.
Location: Upper Mezzanine by Electrical Room
Original Comment: Secure compressed gas cylinders(freon) with chain to prevent
tip over.
FAIL 903.3.3 - Obstructed Automatic sprinklers shall be installed with regard to obstructions that will delay
locations. activation or obstruct the water distribution pattern and shall be in accordance
with the applicable automatic sprinkler system standard that is being used.
Automatic sprinklers shall be installed in or under covered kiosks, displays,
booths, concession stands or equipment that exceeds 4 feet (1219 mm) in width.
Not less than a 3-foot (914 mm) clearance shall be maintained between
automatic sprinklers and the top of piles of combustible fibers. Exception:
Kitchen equipment under exhaust hoods protected with a fire -extinguishing
system in accordance with Section 904.
Location: Upstairs closet by Microwave.
Original Comment: Lower storage to a minimum of 18" below fire sprinkler heads.
GENERAL NOTES
JEFF SIEBEL - 02/13/2025 @ 11:37 Annual Inspection $80
JEFF SIEBEL - 02/13/2025 @ 11:38 Hood Cleaning due 3/25, Fire Alarm Due 4/30, Fire Sprinkler Due 3/14
Printed on 02/13/2025 @ 11:47
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REINSPECTION DATE
03/12/2025
CONTACT SIGNATURE
Amel Hudidic
Signed on: 02/13/2025 @ 11:45
INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on: 02/13/2025 @ 11:45
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 02/132025 @ 11:47
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