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�1 ft�y ram= 05/02/2023 06/05/2023 2023-00011249xiir�� $80.00
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Customer#: 6750 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
BOYS & GIRLS CLUB 715 Mulberry St
515 LIME ST WATERLOO, IA 50703
WATERLOO, IA 50703
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 515 LIME ST-4-4-23 FOR BILLING INQUIRY: (319)291-4323
L Description I Total Price
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
6750 05/02/2023 06/05/2023 2023-00011249 $80.00
Less Prepayment $0.00
Total Due—> $80.00
City of Waterloo
WATERLOO FIRE RESCUE l �P1ER�oo
INSPECTION REPORT
BOYS&GIRLS CLUB,515 LIME ST,BLDG 515 LIME ST,WATERLOO/A 50703
DETAILS
Inspection Date:04/04/2023 Inspection Type:Annual Inspection(1Yr) j Inspection Number:7294 ? Shift: N/A Station: N/A
Unit: N/A Lead Inspector:JEREMIAH VANDYKE j Other Inspectors: N/A j Fee:$80.00
STATUS CODE DESCRIPTION •
FAIL 1103.8-Single-and multiple- Single-and multiple-station smoke alarms shall be installed in existing Group I-1 and
station smoke alarms. R occupancies in accordance with Sections 1103.8.1 through 1103.8.3.
Inspector:JEREMIAH VANDYKE-Comments:Smoke alarm tested and failed.Located
at top of steps on 2nd floor.
FAIL 603.4.1 -Labeling. Doors into electrical control panel rooms shall be marked with a plainly visible and
legible sign stating"ELECTRICAL ROOM"or similar approved wording.The
disconnecting means for each service,feeder or branch circuit originating on a
switchboard or panelboard shall be legibly and durably marked to indicate its
purpose unless such purpose is clearly evident.Where buildings or structures are
supplied by more than one power source,markings shall be provided at each service
equipment location and at all interconnected electric power production sources
identifying all electric power sources at the premises in accordance with NFPA 70.
Inspector:JEREMIAH VANDYKE-Comments:Signage needed on or next to door for
Main Electrical Panel.
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STATUS CODE DESCRIPTION
FAIL 603.5-Relocatable power Multiplug adapters,such as cube adapters,unfused plug strips or any other device
taps and current not complying with NFPA 70 shall be prohibited.The construction and use of current
taps.Multiplug adapters. taps and relocatable taps shall be in accordance with NFPA 70 and this code.
Inspector:JEREMIAH VANDYKE-Comments:Can not have extension cords or power
taps plugged into each other(daisy chained.)And cannot have running across floor
;,*gam - . S ittr in walking path causing damage to cord.
4441
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:Clothes Dryer Exhaust Duct system must
be cleaned from the dryer to the outside DOCUMENTED by who and when serviced.
GENERAL NOTES
JEREMIAH VANDYKE-04/04/2023 @ 11:11 11/28/2022 S-(Annual)Fire Alarm HAWKEYE ALARM Reviewed Compliant
JEREMIAH VANDYKE-04/04/2023 @ 11:11 11/02/2022 S-(Annual)Kitchen Exhaust PROSHIELD FIRE&SECURITY Reviewed
Compliant
JEREMIAH VANDYKE-04/04/2023 @ 11:11 11/02/2022 S-Kitchen Hood Suppression PROSHIELD FIRE&SECURITY Reviewed
Compliant
JEREMIAH VANDYKE-04/04/2023 @ 11:12 Fire Extinguishers compliant/serviced by Proshield in May 2022. Due soon for service.
JEREMIAH VANDYKE-04/04/2023 @ 11:12 Contact Black Hawk County Dispatch of any changes for emergency 24 hour contacts in
the event of an emergency at that address. Phone#319-291-2515.
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GENERAL NOTES
JEREMIAH VANDYKE-04/04/2023 @ 11:13 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-04/04/2023 @ 11:13 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-04/04/2023 @ 11:13 Inspection Fee=$80.00
REINSPECTION DATE
05/04/2023
CONTACT SIGNATURE
Bailey Moore Contact Refused
Refusal Reason:N/A emailed.
INSPECTOR SIGNATURE
JEREMIAH VANDYKE 7D
Signed on:04/04/2023 @ 11:14
QUESTIONS ABOUT YOUR INSPECTION?
JEREMIAH VANDYKE
jeremiah.vandyke@waterloo-ia.org
No phone number available
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