10124 EDMONDS WAY10 r z q
FIRE PREVENTION
Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
SNO]HOMISH CO. EDMONDS
FIRE. ` Mountlake Terrace Everett, WA 98208 BRIER
+► 1-12 ❑ MOUNTLAKE TERRACE
DISTR T Phone (425) 55 00 ❑ UNINCORPORATED
wwwFireDistrictLorg Fax (425) 551-1272
LOCATION:
10124 Edmonds Way 98020
FREQUENCY I STATION & SHIFT
PHONE: SCHEDULED
4257783343 DATE DUE ►
UFIR /
161
HOME PHONE:
_ 6'7
HOME PHONE: Zvl° 3 CURRENT
HOME PHONE:CITY YES NO
20 BUSINESS ❑
LICENSE
PERSON CONTACTED: vkL,+67, o '�Z INITIAL INSPECTION DATE
NAME OF INSPECTOR: VC,f
FIRE SYSTEMS:. AS 9/16 FA 9/16 FE 05/17 HD (3)5/17 12:00:00 AM
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BUSINESS NAME:
McDonald's #4637
MAILING
ADDRESS:
10124 Edmonds Way, Edmonds, WA 98020
BUSINESS OWNER:
Moncrief, Kathi
EMERGENCY-1:
KEY ACCESS-2Victor Lopew— LO C Z
EMAIL:
LOCATIONS / COMMUNICATIONS
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1
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3
4
4
5
5
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7
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYO
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1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE: �•
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED: -
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
_
3
7
3
-
7
RETURN RECEIPT
RECEIVED
4
18
4
8
DATE:
DISPOSITION:
8
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO