HomeMy WebLinkAbout2825 CROSSROADS BD SUITE A INVOICE DATE DUE DATE INVOICE# TOTAL DUE
b\ip.„ 04/03/2018 05/10/2018 2018-00000263 $100.00
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Customer#: 22947 Please Make Check Payable and Remit To:
City of Waterloo
ATTN. City Clerk/Accounts Receivable
CPOTLE MEXICAN GRILL 715 Mulberry St
HI
2825 CROSSROADS BLVD SUITE A WATERLOO, IA 50703
WATERLOO,IA 50702
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-2825 CROSSROADS BD SUITE A-3- FOR BILLING INQUIRY: (319)291-4323
23-18
LDescription Total Price
REINSPECTION 1 $100.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
22947 04/03/2018 05/10/2018 2018-00000263 $100.00
Less Prepayment $0.00
Total Due-* $100.00
City of Waterloo
REIi SPECTION - Commercial Fire Inspection Form
Inspection Number 1272
Inspector* Barry Stratton
File Upload
Address* 2825 Crossroads Bd Suite A
Business Name Chipotle Mexican Grill
Inspection Date* 3/23/2018
Proprietor Hector Hernandez
Business Phone 319-226-5801
Email* h.hernandezl@chipotle.com
Email 2
Property Owner
Emergency Contact Hector Hernandez
Information
Phone 816-728-5085
Violations
Ref# Code Violation &Location Corrected
1 904.11.6.2 Provide current semi-annual kitchen hood fire
suppression system inspection/testing with all deficiencies
corrected by a contractor certified to work in the State of
Iowa
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 I$200-Third and subsequent Re-inspections
Reports
Reports
Comment
Inspection Fee $ 100.00
1 y
Occupancy Fee
Re-inspection Fee
Total Fee* $ 100.00
Received By Hector Hernandez
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload(for long
inspections)
Reinspection
Re-inspection Date Time
3 4/2/2018