Inspection

Inspection Details

Equipment ID
22096

Inspection Date
6/18/2019

Inspection Type
Annual Inspection

Inspector Name
Wayne Ingram

Mechanic Name
Kevin Crossland

Relief Valve Pressure
500

Slide

Governor Rope Pull

Door Closing Force
18

External ID
25fa1e79-c282-43df-abf9-720653162de2

Location

Kerry and Synda Douglas Medical Center
1155 W PARKVIEW ST, BOLIVAR, MO

Owner

Attn: Citizens Memorial Health Care Foundation
Citizens Memorial Health Care Foundation
1500 N OAKLAND AVE, BOLIVAR, MO 65613
Phone: (417) 328-7884
Email: justin.bryant@citizensmemorial.com

Billing

Same as Owner

Violations

Code	Item	Section	Reinspection	Red Tag	Reason For Violation	Fixed Date
MO Minimum : Elevators	(G) - Maintenance, Repair and Replacements	8.6.1.2.1 General Maintenance Requirements Documentation			Must provide MCP	12/7/2021
A17.1-2016 : Elevators	6.4 - Firefighters' service (A17.1b-1989 and later editions)	2.27.3	x	x	Must Make Phase I Fire service Key switch operable. 2.27.3	6/6/2024
ASME A17.1 2004 with 2005 Addendum and 2005 : Elevators	1.6 - Car emergency signal	2.27.1 Phone or alarm not functioning (Mandatory Re-Inspection due in 14 days)	x		PHONE MUST BE MADE OPERABLE

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