HomeMy WebLinkAbout2834 ANSBOROUGH AVE (2) INVOICE DATE DUE DATE INVOICE# TOTAL DUE
Infaa,�`\` �� 2 18' 03/20/2018 2018-00000180 $100.00
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Customer#: 20752 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
HY-VEE#1 715 Mulberry St
2834 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-2834 ANSBOROUGH AVE-2-7-18 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
20752 02/14/2018 03/20/2018 2018-00000180 $100.00
Less Prepayment $0.00
Total Due $100.00
City of Waterloo
•
Commercial Fire Inspection Report
Inspection Number 1264
Prior Inspection 241
Number Fill this field if it is available, it will auto-fill business name and address.
Inspector* Jeff Siebel
Waterloo Fire Rescue
715 Mulberry Street Waterloo, IA 50703
Phone(319)-230-1224 Fax. (319)-291-4262
Email:Jeff.Siebel@waterloo-ia.org
File Upload
Address* 2834 Ansborugh Avenue
Business name Hy-Vee
Inspection Date* 2/7/2018
Proprietor Ray Burks
Business Phone 319-233-3266
Email* 1860asstdirsop@hy-vee.com
Email 2 1860director@hy-vee.com
Property Owner Travis Wirth
Emergency Contact Travis Wirth
Information
Phone
Violations
Ref# CODE Violation &Location Corrected
1 609.3.3.1 Provide current semi-annual kitchen hood exhaust system
cleaning/inspection report with all deficiencies corrected.
2 904.11.6. Provide current semi-annual kitchen hood fire suppression system
2 inspection/testing with all deficiencies corrected by a contractor
certified to work in the State of Iowa
3 Provide documentation of emergency egress and exit light testing
with all discrepancies corrected with a signature and date.
4 Provide annual fire extinguisher service.
5
Ref#
CODE Violation &Location Corrected
r
6
Remove surface mounted slide bolt lock from emergency exit door
on back stock door. (Strictly Prohibited repeat violation
7 Remove snow blower(gas)from building.
8 Remove extension cords behind coolers by check out#8 and salad
cooler. Install permanent outlets with proper permits and
inspections.
9 Provide oily waste receptacle for all grease laden materials in
kitchens.See attached.
10 Microwave in upstairs employee break area must plug directly into
wall outlet. Install permanent outlet with proper permits and
inspections. (Repeat Violation)
11 Upstairs Electrical Room:
Remove obstructions. Maintain a minimum of 36"clearance to and
around electric panels, pull stations,fire extinguishers and
transformers.
Repeat violation: Install permanent signage on electrical panels
and transformers stating"No Storage maintain 36"clearance"
Further violations will result in no storage allowed
12 Reduce storage to a minimum of 18"below ceiling in storage room
next to communication room.
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 Annual Fire Sprinkler
Comment Black Hawk Sprinklers
Reports Annual Fire Alarm
Comment A plus 1/23/18
Reports Annual Generator Service
Comment EEE 5/1/17 noted storage to close to generator. Maintain a minimum of 36"
clearance.
Reports Annual Generator Load Test
Comment EEE 5/1/17
Inspection Fee $ 90.00
Occupancy Fee $ 10.00
Re-inspection Fee $
Total Fee* $ 100.00
Received By Ray Burks
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload(for long listed grease rag bucket picture-vendors.pdf 117.17KB
inspections)
Reinspection
Re-inspection# Date Time
1 2/28/2018