HomeMy WebLinkAbout2003-Letter (plumbing plan review - cross connection control) - � • Safety and Buiidings
10541N RANCH ROAD
HAYWARD WI 54843
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` I�7VOnsI� � . vnvw.commercestate.wi.us/sb
www.wisconsin.gov
Department of Commerce
Jim Doyle,Governor
Cory L.Nettles,Secretary
Apri103,2003
CUST ID No.233083 ATTN:Plumbing Inspector
JEFFREY D OGDEN MUNICIPAL CLERK
OGDEN PLUMBING CITY OF OSHKOSH
PO BOX 689 PO BOX 1130
NEENAH WI 54957 OSHKOSH WI 54903-1130
CONDITIONAL APPROVAL Identificarion Numbers
PLAN APPROVAL EXPIRES: 04/03/2005 Transaction LD No.851688
SITE: Si[e ID No.641759
A-c Compressor/Ge Power System Plant Please refer to both idenrification numbers,
3300 Medalist Dr above,in all correspondence with the agency.
City of Oshkosh, 54901
Winnebago County
FOR:
Descriprion: Serving Hottse Machine
Object Type: Cross Connection Contral Device Regulated Object ID No.: 896374
Device Type:Reduced Pressure Preventer; Locarion On Property: W Wall In Receiving; Manufacturer:Watts; Model:
909QT; 1-1/2"Valve Size
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner,as defined in
chapter 101.01(10),Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during conshuction or installation and prior to occupancy or use:
RPPBP Installation Reminders:
• The backflow preventer shall be installed so that the relief valve ou[let is protected by an approved air-
gap. The drain from the relief valve must discharge to either a floor drain or an approved receptor.
• Comm 82.41(5)(e).The tloor drain or receptor to receive the discharge of the reduced pressure principle
backflow preventer relief valve shall be sized to handle the anticipated discharge.
• Comm 84.10 Materials used in the installation shall be in accord with this chapter
• Comm 82.40(3)(d)a.Nonpotable water shall be identiSed nonpotable by tags or yellow bands.
• Comm 82.40(3)(d)3.The installation of each RP,RP detector,PVB and SVB shall display a department
assigned Regulated Object identification number(see above). The enclosed"Tag"shall be attached to
the installed RPPBP.
• RP,PVB,or SVB's shall not be by-passed. Except for repair,they shall not be made inoperative or
removed without departmental appraval.
• It is the responsibili[y of the owner to make sure the device is tested a[installation and once a year
thereafter.Also that test report forms(SBD-9927)are sent to the Safety and Buildings Division upon
completion of the test. A department-listed Backflow Prevention Device Tester shall pertorm the test. A
list of testers is available from the department upon request.
, , JEFFREY D OGDEN Page 2 4/3/03 li
A copy of the approved plans,specifications and this letter shall be on-site during construction and open to
inspecfion by authorized representatives of the Departrnent,which may include local inspectors. All pernuts
required by the state or the local municipality shall be obtained prior to commencement of
constntction/installarion/operation.
In granting this approval the Division of Safery&Buildings reserves the right to require changes or additions
should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this
review shall relieve the designer of the responsibility for designing a safe building structure, or component.
Inquiries conceming this correspondence may be made to me at the telephone number listed below,or at the address
on this letterhead.
Sincerely, Fee Requ'ued$ 125.00
�� �� Fee Received$ 125.00
�
Balance Due $ 0.00
Thomas E Devereaux
Plumbing/POWTS Reviewer II,Integrated Services WiSMART code: 7657
(715)634-3026,7:15 am-4:00 pm Mon. -Fri.
tdevereaux@commerce.state.wi.us
cc: James E Zickert,Plumbing Consultant,(920)948-7336
A-c Compressor/Ge Power Systems