HomeMy WebLinkAbout1503 E SAN MARNAN STE A . INVOICE DATE DUE DATE INVOICE# TOTAL DUE
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�,��11� � 02/14/2018 03/20/2018 2018-00000192 $80.00
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Customer#: 20784 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
PANDA EXPRESS 715 Mulberry St
1503 E SAN MARNAN DR WATERLOO, IA 50703
WATERLOO,IA 50702
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 1503 E SAN MARNAN SUITE A -2- FOR BILLING INQUIRY: (319)291-4323
13-18
L Description Total Price
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
20784 02/14/2018 03/20/2018 2018-00000192 $80.00
Less Prepayment $0.00
Total Due $80.00
City of Waterloo
Commercial Fire Inspection Report
Inspection Number 1286
Prior Inspection Fill this field if it is available, it will auto-fill business name and address.
Number
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* 1503 San Marnan Suite A
Business name Panda Express
Inspection Date* 2/13/2018
Proprietor Samantha Khamuongsa
Business Phone 847-346-2074
Email* Samantha.khamuongsa@pandarg.com
Email 2
Property Owner Samantha Khamuongsa
Emergency Contact Samantha Khamuongsa
Information
Phone 847-346-2074
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 approved listed oily waste container with self closing lid for
all grease laden materials. (See Attached).
4 Remove obstructions. Maintain a minimum of 36"clearance to
water heater at all times.
Ref# CODE Violation &Location Corrected
5
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 Fire Extinguisher Service
Comment 1/18
Inspection Fee $ 70.00
Occupancy Fee S 10.00
Re-inspection Fee $
Total Fee* $ 80.00
Received By Samantha Khamuongsa
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 2/6/2018