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Home My WebLink About241 E Foothills Pkwy - Special Inspections/Field Verification - 01/25/2016Colorado Department of Labor and Employment Phone: 303-318-8497 Division of Oil and Public Safety - Conveyance Program Fax: 303-318-8534 ',t:..::.;`• 633 17'h Street, Suite 500 Email: cdle_conveyance@state.co.us Denver, CO 80202-3610 Web: vnnv.colorado.govlops c , �'' '� ...� ro ��.I., 1 Report.. 4 .�� it �•'E. t dr y I )' C. �.� .. (Revised 8/1212015) .. To receive a Certificate of Operation, the Conveyance Responsible Party (owner/operator) must submit this Inspection Report, along with the $30 processing fee (payable to the Division of Oil and Public Safety), to the Conveyance Program at the address listed above. Facility Information _ Facility Name: Foothills Activity Center - Facility Address: 241 E. Foothills Pkwy �— Facility ID #: . 36713 . City: Ft. Collins - - Phone County_ Larimer ZIP: - -- _�- Responsible Partv Information Contact Name: Robert Walter Company Name: 'Walton Foothills Holdings VI LLC Address: 5750 DTC Parkway _ City: I Greenwood Village State: Co _ ZIP_ ao111 Phone #: 303-771-4004 Email Address: nrralter@albdev.com Responsible Party Type:- � Otiyner H Facility Management -... - - . Conve}lance Information _ _ Conveyance #:—r CP-15-000322 _ job/Contract #: J3565 _OPS Original Code Data Plate Year: 2013 Year Installed: 2016 Manufacturer: Schindler Altered Code Data Plate Year: n/a Year Altered: -- nla Conveyance Local ID #: #11 Conveyance Use: ❑ Passenger ❑ Service ❑ Freight Freight Class: ElA ❑ B -❑ C1 --❑ C2 ElC3 Conveyance ❑ Traction ❑ Roped -Hydraulic ❑ Vertical PL ❑ Dumbwaiter ❑ Home Elevator in Commercial Bldg. Type: 0 Hydraulic 11 LULA ❑ Inclined PL ❑ Material Lift Other: Front Landings: 3 Rear Landings (if applicable): 1_-- _❑ 0 Rated Speed: 125 fpm ---- -.---._._.._--.--- _ � Capacity: 3500 Ibs Total Rise: 27' 2" ft Maintenance Contractor: Schindler - Inspection Information _ Inspection Date: 1-22-16 StartTime: 10:00,m -- _ - - ❑ Periodic 0 Acceptance (notify OPS) ❑ Test Witnessed — Permit #: _ —�- IP15-000164 - --_ 0 Category 1 ❑Category 5 Inspection Type: ❑ Re -inspection Type: Major Minor Annual Safety Test Date: 1-22-16 _j _❑ _❑ Witnessed Safety Test Date: 1 -22-16 1 Test tags in place?� — ®Yes ❑ No Code Reference Violation Description (Check if additional violations listed on next page: ❑) Repeat Violation TCO Violation Date Corrected (Inspector only) Edition Year Reference Maintenance Control Program (MCP) 1. General Requirements: Yes (77'. No A17.1 2013 8.6.1.2 2. On -Site Documentation: I?1' Yes �i -, � No ❑ ❑ 3. Maintenance Records: -i Yes !❑ No Comments: - --� -_ - --- --�-� --^-------- -.— All Violations Resolved �-- - -- _-..-------- Good For CO ❑ ❑ El El Inspection Result: 21 Annual CO' ❑Temporary CO2 ❑ Construction CO ❑ Removed from service_- ❑ Dormant _ All violations must be corrected prior to the next inspection. 2 TCO and repeat violations must be corrected within 90 days of the date of this inspection. Certification. Information. By signing below I certify that all statements made in this report are true to the best of my knowledge and that the inspection was performed according to current regulations and adopted codes. -- Inspector Name: Anthony Miller Inspection Company Name: A Smart Elevator Solution _ Inspector Signature f Date: 1-25- l i? Phone",: 720-636-3056 State License #: CI-1-513 Colorado Division of Oil and Public Safety Elevator Inspection Report Form Page 1 of 2 7�//_/ //t7/kl Colorado Department of Labor and Employment Phone: 303-318-8526 "''` "" Division of Oil and Public -Safety - Conveyance Section Fax: 303-318-8534 63317th Street, Suite 500 Email: cdle_conveyance@state.co.us Denver, CO 80202-3610 Web: www.colorado.gov/ops COIN VEIr IANCE REGIST ATION NOTICE (REVISED 11/2014). _ The Elevator- and,Escalator Certification Act requires that all regulated conveyances be registered with the Colorado Division of Oil and Public Safety (OPS) before they are placed into service. To register conveyances, submit this form, along with a. check made payable to UPS for the registration fees'($200 per conveyance), to the address listed above. Building Information Building Name: Foothills Activity Center uBuilding Address: 241 E. Foothills Parkway __----_---- — — __ City: Fort Collins County: Larimer —ZIP: 80525 Is this building a Federal facility? F1 Yes 0 No Is this building a State facility? El Yes 10 N.o -......._... ---- ........... ..__ ......... - .. _............ ...... ... .... -. Owner/Management Company Information _ Owner/Management Company Name: Walton Foothills Holdings VI, LLC Owner/Management Company Address: .5750 DTC Parkway, Suite 210 --_ —` City: Greenwood State: Colorado DID: 80.11. - Contact Name: Robert Waltee Phone Number: (303) 771-4004 — Email Address: rwalter@albdev.com Fax Number, (303) 771-40.86 Conveyance Information (if registering more than 5 conveyances, Conveyance Number (for OPS use only) -- submit 1 CP#� — - - - -- additional 2 CP# ---...---------- copies of this 3 _ CP# -—....._.... form.) _ -._— 4 --_: CP# --- _--5 __— CP#.. --------- _..... ... .._..._....._._.... ...... ....... .._......_.:- -- - - .._....._.. Conveyance Type (hydraulic elevator, traction Elevator elevator, escalator, moving walk, ` inclined/vertical platform lift, etc.) — Conveyance Job/Contract number or serial number (located on the conveyance controller)_ J3565 Other Owner Designation' 1 __........ ... ---------- Number of landings ---------------- 3 Passenger (P) or Freight (F) P _ New Installation (N) or Existing Conveyance (E)Z N Year Installed Manufacturer Name N/A Schindler --.....__.._- ----...........-------- — ---- -- _ Capacity (in pounds) .__._............ 3500 - _ Dimensions of floor in feet (elevators only) (for example, 5 ft x 5 ft or 25 ft2) 1 „ „ 5'-5 /z X 6'-9 —�— Elevator door operation (manual or powered) Powered ' Enter any other designation ID assigned to the conveyance by the owner or regulating jurisdiction. ( 2 Indicate whether the conveyances are newly installed or already existing at time of registration. jTotal Registration Fee enclosed: I Total Number of Conveyances Registered: (Number of Conveyances x $200.00) $ 200..00 - - For OPS Use Only Check Date: Check #: Check Amount: r Issuer: Colorado Division of Oil and Public Safety www.colorado.l?ovlops The owner shall keep this Certificate of Operation on file as evidence of compliance. It is also recommended that a copy be posted in the conveyance machine room along with a copy of the last inspection report to facilitate communication and coordination between the inspector and maintenance personnel. Report inaccuracies to the Conveyance Section at (303) 318- 8497. �/ / �/ Note: All deficiencies noted on the inspection report must be corrected prior to the next annual inspection. o'd' Coto . Conveyance Annual Certificate of Operation * Ni ' '1876� Property/Facility #: 36713 Conveyance #: CP15-000322 Conveyance Type: Elevator Local ID: #1 Contract / Job #: J3565 Capacity (Ibs): 3500 Total Rise (ft): Rated Speed (fpm): Owner/Management Company: WALTON FOOTHILLS HOLDINGS VI LLC 5750 DTC PKWY STE 210 GREENWOOD VILLAGE CO 80111 Inspection Date: 01/22/2016 Certificate Issue Date: 01/25/2016 Certificate Expiration Date: 01/31/2017 Inspected by: Mechanic ID: Contractor: Last Witness Test: Property/Facility Information: FOOTHILLS ACTIVITY CENTER 241 E FOOTHILLS PKWY FORT COLLINS CO 80525 CI-1-513 This certificate is issued pursuant to Colorado Conveyance Regulations (7 C.C.R. 1101-8) certifying that at the time of issuance this conveyance was in compliance with current codes adopted in the Colorado Conveyance Regulations. This Certificate of Operation issued by: Colorado Department of Labor and Employment Division of Oil and Public Safety Conveyance Section 633 17th Street, Suite 500 Denver, CO 80202-3610 Phone: (303) 318-8497 Fax: (303) 318-8534 Website: www.colorado.gov/cdle/conveyances