HomeMy WebLinkAbout111 E DONALD ST WA T INVOICE DATE DUE DATE INVOICE# TOTAL DUE
11/15/2023 12/20/2023 2024-00000170 $100.00
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Customer#: 23301 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
KWIK STAR 715 Mulberry St
111 E DONALD 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- 111 E DONALD ST- 10-20-23 FOR BILLING INQUIRY: (319)291-4323
LDescription I Total Price
REINSPECTION 1 $100.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
23301 11/15/2023 12/20/2023 2024-00000170 $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.
WATERLOO FIRE RESCUE �ptERCpO
INSPECTION REPORT
KWIK STAR,111 E DONALD ST,BLDG 111 E DONALD ST,WATERLOO IA 50703
DETAILS
Inspection Date: 10/20/2023 ! Inspection Type:Annual Inspection(1Yr) I Inspection Number: 11136 I Shift: N/A I Station: N/A
Unit: N/A I Lead Inspector:JEFF SIEBEL I Other Inspectors: N/A
STATUS CODE DESCRIPTION
FAIL 1203.2.15-Means of egress Emergency power shall be provided for means of egress illumination in accordance
illumination. with Sections 1008.3 and 1104.5.1.
Inspector:JEFF SIEBEL-Comments:None
Location:Above real fruit smoothie machine
FAIL 606.3.3.3-Records. Records for inspections shall state the individual and company performing the
inspection,a description of the inspection and when the inspection took place.
Records for cleanings shall state the individual and company performing the cleaning
and when the cleaning took place.Such records shall be completed after each
inspection or cleaning and maintained.
Inspector:JEFF SIEBEL-Comments:Provide current semi-annual kitchen hood
exhaust cleaning inspection report with all discrepancies corrected.Contractor must
post online to the compliance engine.Currently 35 days past due.
Location: Not Provided
GENERAL NOTES
JEFF SIEBEL-10/24/2023 @ 11:20 re-inspection fee$100
REINSPECTION DATE
11/13/2023
CONTACT SIGNATURE
Corporate
Signed on: 10/24/2023 @ 11:20 (i c L
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Printed on 10/24/2023 @ 11:23
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INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:10/24/2023 @ 11:20
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 10/24/2023 @ 11:23
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