10307 238TH ST SWSNOTiOMTSH CO.
III i�� 111 t 03 o7 z 3 94ti s-T sw
Serving Brier, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
DI,STRIC,,Twww.FireDistricti.org
LOCATION:10307 238 th Street SW 98026
BUSINESS NAMEKIahaya Swim & Tennis Club
MAILING
ADDRESS`.10307 238th Street SW, Edmonds, WA 98026
BUSINESS OWNER:
EMERGENCY -'McDowell. Jeff
KEY ACCESS-2:
EMAIL:
PERSON CONTACTED: AQ P,1A1A
NAME OF INSPECTOR: A. PIVAS / S-
FIRE SYSTEMS: FE 5/,17
D t L st Serviced:
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 2065423211
HOME PHONE:
HOME PHONE: 2062266602
HOME PHONE: 20
FIRE PREVENTION
INSPECTION REPORT
DMONDS
BRIER
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY STATION & SHIFT
Annual 20-B
SCHEDULED Jun 2018
DATE DUE 0
UFIR 1 116
CURRENT
CITY
YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
ae a
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
nlb HA2 A R7s nary
2
2
3
3
4
4
5
5
6
6
_
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
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: r
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
3
4
...�..
8
7 _
8
2
6
DATE:
CODE
SECTION:
5
3
7
RETURN RECEIPT
RECEIVED
DATE:
DISPOSITION:
e
7.
4
8
LETTER NEEDED ❑ YES ❑ NO
_ _
'LETTER NEEDED ❑ YES ❑ NO
B