INSP - VA Bonham
Updated
A PDF document (1.2 MB) attached to NTX Elevator Inspection, from the Department of Veterans Affairs. Due Nov 9, 2026, 3:00 PM (UTC-6).
File name: INSP - VA Bonham Sept 2025.pdf
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VA BONHAM $QQXDO EOHYDWRUIQVSHFWLRQ
INSPECTION DATA - TO BE COMPLETED BY INSPECTOR
1. Unit #
Bonham
2.Site Name:
3. Contract #:
Sam Rayburn Memorial Bldg 1
5. Building Name:
Building Physical Address: 1201 E 9th St
x
Pass
x
Electric
P1
TX
75418
City
State
Zip
Esc.
11. Year Installed
10.Drive Machine: (check one)
N/A
Building Designation:
Bonham
Number, Street, Suite No., Apt. No.
9. Type of Unit: (Check one)
4. Removed from Service Date:
M.W
Frt
W.L.
12. Year Altered
Other (specify)
17. Due Date for Next 5 year Safety Test:
15. Capacity
MCE
7. Model Type:
HMC 4000
8. Serial Number:
3275853
Other (specify) :
13. # of Floors
2010
Hydraulic
14. Speed
LULA
6.Manufacturer:
16. # of Car Openings
4000
19. Type of Inspection (check all that apply)
X
2029
Annual
New Installation
Alteration
Re-Inspection
Accident
5 Year Test
OTHER
Semi-Annual
18. Test Data Tag in Place:
Yes
No
Item #
Rule
Code Year
Violations (Use page ELE2a if additional pages are necessary)
A17.1 8.6.1.4.1
2016
A17.1 3.27.3
2016
A17.1 3.27.3
2016
A17.1 2.2.5
2016
MCP's - PROVIDE Fire Logs, Periodic Test Tag
Repair Fire Phase I hall indicator
Repair Fire Phase I car indicator
Repair Pit lighting
Check box if page 2 attached
Repeat
YES
YES
21. Comments:
Annual inspection and testing per A17.1 and A17.2 elevator code. Testing done by Eugene M Kissinger - QEI C-5598, elevator inspector for Reliant Elevator Inspections & Consulting, LLC. Elevator test performed correctly and passed with the violations noted above.
22. INSPECTOR SIGNATURE IS REQUIRED FOR CERTIFICATE PROCESSING
I certify that this is a true report of my inspection. I further certify that the information on this report is correct.
C-5598
EugHQH0.LVVLQJHU
QEI INSP LIC#
Inspector Name Printed
signed by E. M. Kissinger
E. M. Kissinger Digitally
Date: 2025.09.29 15:35:30 -05'00'
Date Inspection Completed
CONTACT INFORMATION - TO BE COMPLETED BY OWNER OR OWNER AGENT
24. Building Contact Name:
John Dupeire
Contact Phone Number:
903-583-6493
Area Code
Building Contact Business/Public Email Address:
Phone Number
Building Contact Mailing Address:
1201 E. 9th Street
Number, Street, Suite No., Apt. No.
(Ex. [email protected])
9/29/2025
Bonham
TX
City
State
See instruction sheet for disclosure information
25. Elevator Mechanic Name:
Elevator Company: Metro Elevator
Ryan Irwin & Jay Tonn
4602 Deepdale Drive
Ƈ
Corpus Christi, Texas 78413
Ƈ
832-734-9977
75418
Zip
9$%21+$0 $QQXDO(OHYDWRU,QVSHFWLRQ
INSPECTION DATA - TO BE COMPLETED BY INSPECTOR
2 0f 9
1. Unit #
Bonham
2.Site Name:
3. Contract #:
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