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Home My WebLink About1117 MAXHELEN BLVD INVOICE DATE DUE DATE INVOICE# TOTAL DUE 07/18/2023 08/20/2023 2024-00000042 $100.00 11 f f7 rir:nr■l/Iii}Y tff+ V i. . • ayis. . Y 837 Customer#: 24126 Please Make Check Payable and Remit To: City of Waterloo ATTN: City Clerk/Accounts Receivable SOUTH HILLS SENIOR LIVING 715 Mulberry St 1117 MAXHELEN BLVD WATERLOO, IA 50703 WATERLOO, IA 50702 Amount Enclosed: DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT KEEP THIS PORTION FOR YOUR RECORDS COMMERCIAL INSPECTION - 1117 MAXHELEN BLVD - 5-16-23 FOR BILLING INQUIRY: (319)291-4323 Description I Total e �. Price ce INSPECTION 20,000 $90.00 OCCUPANCY FEE $10.00 CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES 24126 07/18/2023 08/20/2023 2024-00000042 $100.00 Less Prepayment $0.00 Total Due $100.00 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. ►,. . ; `magi WATERLOO FIRE RESCUE IRO V w „ocutto, INSPECTION REPORT `r Z�SOUTH HILLS SENIOR LIVING,1117 MAXHELEN BLVD,BLDG 1117 MAXHELEN BLVD, ea ' ‘" ozzitio , f WATERLOO IA S0702 . DETAILS Inspection Date:05/16/2023 Inspection Type: Residential Common Areas Inspection I Inspection Number: 10264 I Shift: N/A I Station: N/A I Unit: N/A Lead Inspector:JEREMIAH VANDYKE I Other Inspectors: N/A I Fee:$100.00 STATUS CODE DESCRIPTION FAIL 1203.4-Maintenance. Emergency and standby power systems shall be maintained in accordance with NFPA 110 and NFPA 111 such that the system is capable of supplying service within the time specified for the type and duration required. Inspector:JEREMIAH VANDYKE-Comments:Generator for building and life safety systems. Location: Not Provided FAIL 1203.4.2-Schedule. Inspection,testing and maintenance of emergency and standby power systems shall be in accordance with an approved schedule established upon completion and approval of the system installation. Inspector:JEREMIAH VANDYKE-Comments:Generator for building and life safety systems. Location: Not Provided FAIL 1203.4.3-Records. Records of the inspection,testing and maintenance of emergency and standby power systems shall include the date of service,name of the servicing technician,a summary of conditions noted and a detailed description of any conditions requiring correction and what corrective action was taken.Such records shall be maintained. Inspector:JEREMIAH VANDYKE-Comments:Generator for building and life safety systems. Location: Not Provided Printed on 05/177/2023 @ 09:01 Page 1 of 5 STATUS CODE DESCRIPTION FAIL 1203.4.4-Switch Emergency and standby power system transfer switches shall be included in the maintenance. inspection,testing and maintenance schedule required by Section 1203.4.2.Transfer switches shall be maintained free from accumulated dust and dirt.Inspection shall include examination of the transfer switch contacts for evidence of deterioration. When evidence of contact deterioration is detected,the contacts shall be replaced in accordance with the transfer switch manufacturer's instructions. Inspector:JEREMIAH VANDYKE-Comments:Generator for building and life safety systems. Location: Not Provided FAIL 1203.6-Supervision of Routine maintenance, inspection and operational testing shall be overseen by a maintenance and testing. properly instructed individual. Inspector:JEREMIAH VANDYKE-Comments:Generator for building and life safety systems. Location: Not Provided FAIL 509.1 -Identification. Fire protection equipment shall be identified in an approved manner. Rooms containing controls for air-conditioning systems,sprinkler risers and valves,or other fire detection,suppression or control elements fire protection systems shall be identified for the use of the fire department.Approved signs required to identify fire protection system equipment and equipment location shall be constructed of durable materials,permanently installed and readily visible. Inspector:JEREMIAH VANDYKE-Comments:Signage stating'Sprinkler Riser Room" constructed of durable materials,permanently installed and readily visible. Location: 1st floor mechanical room door. FAIL 610.1.2-Maintenance. The lint trap,mechanical and heating components,and the exhaust duct system of a clothes dryer shall be maintained in accordance with the manufacturer's operating instructions to prevent the accumulation of lint or debris that prevents the exhaust of air and products of combustion. Inspector:JEREMIAH VANDYKE-Comments: Record log of cleaning with date and name for all clothes dryer systems. Location: Not Provided Printed on 05/17/2023 @ 09:01 Page 2 of 5 STATUS CODE DESCRIPTION FAIL 703.1 -Maintaining Materials and firestop systems used to protect membrane and through penetrations protection. in fire-resistance-rated construction and construction installed to resist the passage of smoke shall be maintained.The materials and firestop systems shall be securely attached to or bonded to the construction being penetrated with no openings visible through or into the cavity of the construction.Where the system design number is known,the system shall be inspected to the listing criteria and manufacturer's installation instructions. Inspector:JEREMIAH VANDYKE-Comments:Holes to be repaired with fire resistance material.Currently working on leak. Location: Near room#205 House keeping room. FAIL 704.1 -Maintaining Where required when the building was originally constructed, materials and systems protection. used to protect joints and voids in the following locations shall be maintained.The materials and systems shall be securely attached to or bonded to the adjacent construction,without openings visible through the construction. 1.joints in or between fire-resistance-rated walls,floors or floor/ceiling assemblies and roof or roof/ceiling assemblies.2.Joints in smoke barriers.3.Voids at the intersection of a horizontal floor assembly and an exterior curtain wall.4.Voids at the intersection of a horizontal smoke barrier and an exterior curtain wall.5.Voids at the intersection of a nonfire-resistance-rated floor assembly and an exterior curtain wall.6.Voids at the intersection of a vertical fire barrier and an exterior curtain wall.7.Voids at the intersection of a vertical fire barrier and a nonfire-resistance-rated roof assembly. Unprotected joints and voids do not need to be protected where such joints and voids were not required to be protected when the building was originally constructed.Where the system design number is known,the system shall be inspected to the listing criteria and manufacturer's installation instructions. Inspector:JEREMIAH VANDYKE-Comments:Ceiling tiles need to be replaced. Location: Located in kitchen. FAIL 705.2.4-Door operation. Swinging fire doors shall close from the full-open position and latch automatically. Inspector:JEREMIAH VANDYKE-Comments:Door stops not allowed on fire rated doors. Door did not close and latch due to catching on carpet. Location:2nd floor laundry residents laundry room. Printed on 05/17/2023 @ 09:01 Page 3 of 5 STATUS CODE DESCRIPTION FAIL 901.6-Inspection,testing and Fire detection and alarm systems,emergency alarm systems,gas detection systems, maintenance. fire-extinguishing systems,mechanical smoke exhaust systems and smoke and heat vents protection and life safety systems shall be maintained in an operative condition at all times,and shall be replaced or repaired where defective. Nonrequired fire protection and life safety systems and equipment shall be inspected,tested and maintained or removed in accordance with Section 901.8. Inspector:JEREMIAH VANDYKE-Comments:According to Compliance engine there are 2 deficiencies called out by Sprinkler Contractor on 7/29/2022.Owner will contact sprinkler contractor to if they have been addressed. 1.Deficiency Found by sprinkler contractor:Answer:4"main on dry system in attic has pipe with pinhole leaks that are now patched and should be replaced 3rd floor north west access 7'-0"pipe overall with 2"welds back to back at 6"off end of pipe and 0-11"piece 3rd floor north east access 4"pipe overall lengths 9'-3"10'-6"2'-4"2.Deficiency Found by sprinkler contractor:Answer:5-chrome pendent heads in kitchen area have corrosion at the seat 155 degree chrome F1 semi recessed pendent could change them to 200 degrees due to them being in the kitchen A Deficiency Notice was sent on 08/15/2022 Location: Not Provided FAIL 99999-Inspection Outcome Did the inspection pass or fail? Inspector:JEREMIAH VANDYKE-Comments: None Location: Not Provided GENERAL NOTES JEREMIAH VANDYKE-05/17/2023 @ 08:09 04/06/2023 S-Kitchen Hood Suppression SUPERIOR FIRE PROTECTION EQUIPMENT Reviewed Compliant JEREMIAH VANDYKE-05/17/2023 @ 08:09 04/06/2023 S-(Annual)Fire Alarm HAWKEYE ALARM Reviewed Compliant JEREMIAH VANDYKE-05/17/2023 @ 08:09 07/29/2022 S-(Annual)Fire Sprinkler BLACKHAWK AUTOMATIC SPRINKLERS,INC. Reviewed Deficient JEREMIAH VANDYKE-05/17/2023 @ 08:10 05/25/2022 L-(Annual)Kitchen Exhaust HARRIS CLEANING SERVICE AND AH Reviewed Compliant JEREMIAH VANDYKE-05/16/2023 @ 15:42 Fire Extinguishers serviced/compliant by Superior Fire in April 2023. Printed on 05/17/2023 @ 09:01 Page 4 of 5 s q • GENERAL NOTES JEREMIAH VANDYKE-05/17/2023 @ 08:58 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 a.m.-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 set up an earlier re-inspection. JEREMIAH VANDYKE-05/17/2023 @ 08:58 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-05/17/2023 @ 08:59 Inspection Fee=$100.00 REINSPECTION DATE 06/16/2023 CONTACT SIGNATURE Dalt Snodgrass Reason for not collecting a signature: NA INSPECTOR SIGNATURE JEREMIAH VANDYKE Signed on:05/17/2023 @ 08:57 LN QUESTIONS AMOUT YOUR INSPECTION? JEREMIAH VANDYKE jeremiah.vandyke@waterloo-ia.org No phone number available Printed on 05/17/2023 @ 09:01 Page 5 of 5