NYC 9/11 Public Portal Document
RANGE HOOD INSPECTION REPORT
y -
BATTALION NO.
Inspection Date:
FOLDER NO.
/ b 6 3o
Restaurant Name: A h if (a
Premise Address:
Boro/Zip: Ma/n bo. fC'O i-/ 7
**<****************«**«***********«*****
Name of system: ________________________________________________
Model No.
System approved? S Yes □ No F.D. Tag No. /&7Ji
Type of inspection: 106 Initial 106 Reinspection
With plans Without plans .y- - Referral V.O.
Does installation conform to F.D. approval plan? ® Yes □ No
V.O. Issued; No.
Semi-annual service conducted by an authorized contractor? S Yes □ No
N.O.V. Issued: No.
Approved grease filters? IH Yes □ No
Maintained properly? 0 Yes □ No
N.O.V. Issued; No
Invoice No. ^-324
Comments; ~~ cz r >
Pi.i
--
'R, T)AS
PRINT INSPECTOR’S NAME
- 2 - c SIGN INSPECTOR'S NAME
r/TP-j
i
‘^1^7 - t/'
6\/7- - J
RHINSP (11/90) 78-903202.1,7
NYC-WTC_000166051
OCR can misread numbers and units. Confirm readings against the page image before using them.