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REINSPECTION - Commercial Fire Inspection Form
Inspection Number 194
Inspector* Jeff Siebel
Waterloo Fire Rescue
715 Mulberry Street Waterloo, IA 50703
Phone(319)-230-1224 Fax. (319)-2914262
Email:Jeff.Siebel@waterloo-ia.org
File Upload
Address* 201 Rath Street
Business Name Packers Inn
Inspection Date* 3/12/2018
Proprietor Donna Engleman
Business Phone 319-234-8456
Email* cindy.young@waterloo-ia.org
Email 2
Property Owner Donna Engleman
Emergency Contact Donna Engleman
Information
Phone 319-230-2880
Violations
Code Violation&Location Corrected
Ref#
4.By cash register:
1
A. Repair/replace light above cash register.Properly
contain exposed wiring with a listed enclosure.
Comments:
If violations noted during the inspection are not corrected by the given re-inspection date,additional fees
are as follows:
$100.00 -First Re-inspection I$150.00-Second Re-insPection $200-Third and subsequent Re-inspections
•
Reports
4 �
Reports
Comment
Inspection Fee S
Occupancy Fee S
Re-inspection Fee S 100.00
Total Fee* $ 100.00
Received By Bartender
AN INVOICE OF THIS CHARGE WILL FOLLOW.DO NOT PAY FROM THIS FORM.
File Upload(for long
inspections)
ReinspectiOn
Re-inspection
Date Time
3 4/5/2018