Inspection

Inspection Details

Equipment ID
10639

Inspection Date
6/19/2025

Inspection Type
Annual Inspection

Inspector Name
Leland Jones

Mechanic Name
Bryan Wright

Relief Valve Pressure
650

Slide
NA

Governor Rope Pull
NA

Door Closing Force
21

External ID
1af8f031-ed43-44fc-8206-0ce39baf2218

Location

Sam's Club #8293 Independence
4100 S Bolger Rd, Independence, MO
Phone: (816) 350-2131

Owner

Attn: Sam’s Club c/o ATIS Elevator Inspections
Sam’s Club c/o ATIS Elevator Inspections
2100 Maplewood Commons, Saint Louis,, MO 63143
Phone: (314) 375-2144 Ext: 1034
Email: samsclub@atis.com

Billing

Same as Owner

Violations

Code	Item	Section	Reinspection	Reason For Violation	Fixed Date
MO Minimum : Elevators	11 CSR 40-5.090 Inspection and Testing	8.6.5.16.5 Over Speed Valve Testing		Must preform Cat. 5 OSV test, seal, and tag 90 days to correct.	3/1/2024
MO Minimum : Elevators	11 CSR 40-5.090 Inspection and Testing	8.6.5.16.5 Over Speed Valve Testing (Re-Inspect)	x	Must perform Cat. 5 test for Overspeed Valve. 8.6.5.16.5	3/1/2024
A17.1-2016 : Elevators	1.6 - Car emergency signal	8.6.4.15 Phone or alarm not functioning (Mandatory Re-Inspection due in 14 days)	x	Must Make Emergency Phone operable. 8.6.4.15	3/1/2024

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