HomeMy WebLinkAboutRP Valve Serving - 4/12/2000 _ � Safety antl Builtlings
13C0 E GREEN BAY ST STE 300
� SHAW ANO W I 54166
TDD p:(608)26a-8]]]
� isconsin �+++wmmerces�ate wi us
Department of Commerce TommyG.Thompson,Governor
Brentla J.BlancharQ Secretary
Aprfl 12,2000
CUST ID No3953 �3'TN:PlumbircglNSPECTOR
Rl KAMPO PLUM6ING&HEATMG MC CITY OF OSHKOSH
1000 S W ESTLAND DR PO BOX 1130
APPLETON WI 54914-8862 OSHKOSH WI 54902-I l30
RE: CONDITIONAI.APPROVAI. IdcntiEcationNumbers
PLAIV APPROVAI,EXPIRES:04/12/2002 Transac[ion ID No.305468
Si[e ID No. 172743
Please refer ro both identification numbers,
SITE:
Si�e(D' 172747, MILES KIM6ALL above,In all cortes ondence with the a enc .
WINNEIIAGO Counry,City ofOSHKOSH; 2155 SOUTH OAKWOOD RD,OSHKOSH 54904
Facility: MILES KIMBALL DISTRIBUTION CTR 2155 SOOTH OAKWOOD RD,OSHKOSH 54904
FOR:
Desceiptiam RP Valve Serving Film Processors
Objeet Type: Cross Connection Control Devfce Regulared Objeet ID Na: 655551
Device Type�. Reduced Pressuce Preveniec, Location on Propecry: NE Corner of[he Building, ManuFacNcec WATTS,
Modcl: 009, Serial No.: 17267, J/4" Valve Size
Descciptiom RP Valve Serviug Film Processors
Object Type: Qoss Connection Control Device Regulared Object ID No.: 655552
Device 7ype: Reduced Pressure Preventer, Location on Property: NE Carner of�he Building, Manufacmrer: WATTS,
Model:009, Serial No.: 11268, 3/4" Valve Size
Descrip[ion: RP Valve Serving[he Wash Room
Object Typc:Cmss Connution Control Device Regulated Object ID No.: 655553
DeviceTypo:Redmed Peessure Peeventer, Location on Property: Print Shop Wash Room, ManuCaclu�ec WATTS,
Model:009, Serial No.: 07757, 3/4" Valve Sizc
Description: RP V ah�e Serving/he Wash Roam
Objec�Type: Cross Connec[ia�Control Devfce Regula�ed Objeet ID Na: 655554
Device Type: Reduced Presmre Prevenrer, Location on Property: Prinl Shop Wash Raom, ManufacNree WATTS,
Model: 009, Serial No.: 07761, 3/4" Valve Size
Descdp�ion: RP Vahe Serving[he Etchiog Room
Objeet Type: Cmss Connectfon Connol Device Regulated Object ID No.: 655555
Device'Cype: ReAuced Pressure Preventee, Lowuon o�Pmperty: Print Shop Etching Roon�, ManufacNrec WATTS,
Model: 009, Serial No.: 07748, 3/4"Valve Size
Desc�ipnon�. RY Valve Serviog ihe Elching Room
Objea Typc Cmss Connection Cantrol Dcvfce Reguleted Object ID Na: 655556
DevieeType: Reduced Presmre Preventer, Location on Propeny Print Shop E�ehing Room, ManuCacturec WA7'TS,
Mo�e1:009, Serial9o.: 17837, 3/4" Valvc Size
The subminel duenbed above has been�eviewed Por conCormance wrth applicable W fsronsfn Adrrunisnative Codes
and Wisconsin Stamres. The subnilual has been CONDI"PIONALLY APPROVGD. The owner, as defined in
chapte� 101.01(10), W isconsin StaNtes,is cespwsible Coe compliance with all code ecquirements. �
The (ollowing condi[ions shall be me�during constmction or insmllation and prior m occupancy or use:
. . �
Rl KAMPO PLUM�ING&HEATING INC Page 3 M1�11/00
1. The back0ow prevenler shall be inslalled so that the reliet valve ouUet is prolecled by an approved air-
gap. The drain(rom the relief valve must discharge[o either a�oor drain or an approved recep[or.IVo
part af[he back0ow preventer may be submerged under any circumstance.
2. A TEST SHALL BE CONDUCTED ON EACH RP,PVB,OR SVB PRIOR TO IT BEING PUT[NTO
SERVICE,AND A MIMMUM OF ONCE A YEAR THEREAFTER.
3. Il is lhe responsibilily of Ihe owner[o make sure Ihe device is tested and Iha[[he test repor[formt(SBD-
992'�is sen�to the Sa@ty and Buildings Division upon comple�ion oC 1he[esl. A deparlmen4listed
Backilow Prevention Device Tesler shall per(orm Ihe[esL A list of[esters is available Crom the
department upon requesl.
A copy of Ihe appmved plans,specifica[ions and[his letter shall be on-si[e during construction and open ro
inspec[ion by authorized cepresentatives of the Depamnent,which may include local inspec[ors. All pemtits
required by the sfa[e or[he local municipaliTy shall be obtained prior to conm�encemen[of
construclion/installation/operation.
Inquiries conceming this rortespondence may be made to me al the telephone number lis[ed below,or a[[he address
on tltis lenerhead.
Sincemly, DATE RECEIVED 03/312000
i
/�«���`�"r� FEE REQUIRED$ 660D0
�c� FEERECEIVED$ 660.00
CURT WENDORFF,PLUMBING PLAN REV[EWER BALANCE DUE $ 0.00
Integrated Services
(715)526-9056, FAX (715)524-3633 , M-R 7:15 -17:00,F 7:15 - 11:15
CW ENDORFF@WMMERCE.STATE.W LUS W iSMART code: 7657
cc:DONALD KAY,PLUMBMG CONSULTANT,(920)834-3093
MILES KIMBALL CO