HomeMy WebLinkAbout2780 CROSSROADS BLVD =wl INd}DICE DATE DUE DATE INVOICE# TOTAL DUE
44 06/15/2021 07/30/2021 2021-00000286 $200.00
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erloo
Customer#: 9993 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
APPLEBEE'S 715 Mulberry St
2780 CROSSSROADS BLVD WATERLOO, IA 50703
WATERLOO,IA 50702
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-2780 CROSSROADS BLVD-3-24-21 FOR BILLING INQUIRY: (319)291-4323
LDescription Total Price J
REINSPECTION 3 $200.00
CUSTOMER# BILLING DATE _ DUE DATE INVOICE# CHARGES
9993 06/15/2021 07/30/2021 2021-00000286 $200.00
Less Prepayment $0.00
Total Due--> $200.00
City of Waterloo
WATERLOO FIR E REFIRFRES CUE q91)
INSPECTION REPORT
APPLEBEE`S,2780 CROSSROADS BLVD;BLDG 2780 CROSSROADS BLVD, WATERLOO IA 50702
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DETAILS
Inspection Date:03/24/2021 1 Inspection Type:Annual Inspection(1Yr) ;,lnsppction Number:5595 l Shift: N/A I Station: N/A 1
Unit: N/A 1 Lead Inspector:JEFF SIEBEL 1 Other Inspectors: N/A 1 Fee:$8 0
STATUS CODE DESCRIPTION
FAIL 609.3.3.3-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
cleaning inspection report with all discrepancies corrected.Contractor must upload
online to The Compliance Engine.495 days past due
FAIL Chapter 14-Inspection, Fire alarm system tested at least annually by licensed contractor
testing,and maintenance
Inspector:JEFF SIEBEL-Comments: Provide current annual fire alarm inspection
report with all discrepancies corrected.Contractor must upload online to the
compliance engine.
GENERAL NOTES
JEFF SIEBEL-03/26/2021 @ 09:13 Re-inspection fee$200
JEFF SIEBEL-03/26/2021 @ 09:16 Met with Calvin onsite 3/24 and explained process. Please provide corrections to avoid
additional re-inspection fees.
REINSPECTION DATE
04/23/2021
CONTACT SIGNATURE
Calvin GM
Signed on:03/26/2021 @ 09:15
C 1 �, _
Printed on 03/26/2021 @ 09:18
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INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:03/26/2021 @ 09:15
QUESTIONS ABOUT YOUR INSPECTION'
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 03/26/2021 @ 09:18
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