HomeMy WebLinkAbout3610 ANSBOROUGH AVE INVOICE DATE DUE DATE INVOICE# TOTAL DUE
Ar."41161R�\�ri�� 11/17/2022 12/20/2022 2023-00010989 $100.00
11
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Customer#: 11638 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
COMMUNITY UNITED CHILD CARE CENTER 715 Mulberry St
3610 ANSBOROUGH AV WATERLOO, IA 50703
WATERLOO, IA 50701
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 3610 ANSBOROUGH AVE- 11-8-22 FOR BILLING INQUIRY: (319)291-4323
LDescription I Total Price
INSPECTION 20,000 $90.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
11638 11/17/2022 12/20/2022 2023-00010989 $100.00
Less Prepayment $0.00
Total Due—± $100.00
City of Waterloo
WATERLOO
FIRE RESCUE 00
INSPECTION REPORT
COMMUNITY UNITED CHILD CARE,3610 ANSBOROUGH AVE,BLDG 3610 ANSBOROUGH AVE,
WATERLOO IA 50701 4240i
DETAILS
Inspection Date:11/08/2022 ; Inspection Type:
•Annual Inspection(1Yr) Inspection Number:7071 : Shift N/A ; Station: N/A
Unit: N/A I Lead Inspector:JEFF SIEBEL I Other Inspectors: N/A I Fee:$100.00
DESCRIPTION
STATUS CODE
FAIL
Type I hood shall be installed at or above all commercial cooking appliances and
A yp purposes
609.2-Where required appliances used for commercial ur oses that produce grease
domestic cooking app•li
vapors. Exception:A Type I hood shall not be required vle s documentation that the
appliance where an approved testing agency pro
appliance effluent contains 5 mg/m^3 or less of grease
U when
7 n tested at an exhaust
flow rate of 500 cfm(0.236 m^3/s)in accordance with
Inspector:JEFF SIEBEL-Comments:Provide written policy stating
the alugge appliance is only
n
used for water,appliance is always attended,and the appliance
not in use.Provide manufactures recommendation for power requirements and
proper clearances.
GENERAL NOTES
JEFF SIEBEL-11/08/2022 @ 15:31
annual inspection$100
JEFF SIEBEL 11/08/2022 @ 15:32 Fire Drills practiced monthly.Last 10/5/22 with Hawkeye Alarm
JEFF SIEBEL 11
/08/2022 @ 15:32 dryer vent cleaned to outside by maintenance 10/5/22
REINSPECTION DATE
11/29/2022
CONTACT SIGNATURE
Amy Junkin
Signed on:11/08/2022 @ 15:38
Printed on 11/08/2022 @ 15:40
Page 1 of 2
INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:11/08/2022 @ 15:38
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 11/08/2022 @ 15:40
Page 2 of 2