HomeMy WebLinkAbout1604 LA PORTE RD INVOICE DATE DUE DATE INVOICE# TOTAL DUE
411� ����: 02/15/2023 03/20/2023 2023-00011132 $200.00
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Customer#: 14658 Please Make Check Payable and Remit To:
City of Waterloo
A TTN: City Clerk/Accounts Receivable
CASEY'S GENERAL STORE-LAPORTE RD 715 Mulberry St
P.O. BOX 3001 WATERLOO, IA 50703
ANKENY, IA 50021
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 1604 LA PORTE RD -2-10-23 FOR BILLING INQUIRY: (319)291-4323
I_Description I Total Price J
REINSPECTION 3 $200.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
14658 02/15/2023 03/20/2023 2023-00011132 $200.00
Less Prepayment $0.00
Total Due--f $200.00
City of Waterloo
SL
WATERLOO FIRE RESCUE 40,-TE 00
INSPECTION REPORT
CASEY'S GENERAL STORE#2880,1604 LA PORTE RD,BLDG 1604 LA PORTE RD,WATERLOO IA
50702
DETAILS
Inspection Date:02/10/2023 Inspection Type:Annual Inspection(1Yr) j Inspection Number:9520 I Shift: N/A j Station: N/A
Unit: N/A j Lead Inspector:JEFF SIEBEL I Other Inspectors: N/A
STATUS CODE DESCRIPTION
FAIL 304.3.1 -Spontaneous Materials susceptible to spontaneous ignition,such as oily rags,shall be stored in a
ignition listed disposal container.Contents of such containers shall be removed and
disposed of daily.
Inspector:JEFF SIEBEL-Comments:Provide an approved listed oily waste container
with self closing lid for oily waste.OPTION:Submit a written corporation plan for
proper handling of oily waste material to prevent spontaneous combustion.
GENERAL NOTES
JEFF SIEBEL-02/12/2023 @ 11:40 re-inspection fee$200
JEFF SIEBEL-02/12/2023 @ 11:42 manager put in work order,but inspection has been opened since 10/13/22
REINSPECTION DATE
03/10/2023
CONTACT SIGNATURE
Treva Gillam GM R
Signed on:02/12/2023 @ 11:45
INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:02/12/2023 @ 11:46
Printed on 02/12/2023 @ 11:48
Page 1 of 2
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 02/12/2023 @ 1 1:48
Page 2 of 2