HomeMy WebLinkAbout2002-Letter (plumbing plan review - cross connection control) 6/4/02 a �
Safety and Buildings �I
, � 4003 N KINNEY COULEE RD I,
LA CROSSE WI 54601-1831
� � TDD#:(608)264-8777
� iscons�n www commerce state wi us/sb
www.wisconsin.gov
Department of Commerce
Scott MCCallum,Governor
Philip Edw.Albert,Secretary
June 04, 2002
CUST ID No233083 A7TN: Plumbinglnspector
JEFFREY D OGDEN MUNICIPAL CLERK
OGDEN PLUMBING CITY OF OSHKOSH
i010 STROHMEYER DR PO BOX I130
�'EENAH Wf 54957 OSHKOSH WI 54903-I130
CONDITIONAL APPROVAL
PLAN .4PPROVAL EXPIRES: 06/0�/2001 [dentification Numbers
Transaction [D No. 753978
SITE: Site [D No. 641759
A-C Compressure/Ge Power System Plant Please refer[o both iden[ifica[ion numbers,
3300 Medalist Dr above, in all corres ondence with [he a�enc �.
Ciry of Oshkosh, 54901
W innebago County
FOR:
Description: Serving Porming Press
Object Type: Cross Connzction Control Device Regulated Object ID No.: 853625
Dzvice��ype: Reduced Pressure Preventer, Location On Property: �1achine S. of Mfg. Oftice; Manufacturec Wans:
Model: 909QT; Plan T}pe: Additiun; l-I/4" Valve Size
The submittal described above has been revia���ed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin 5[a[utes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Stamtes, is responsible for compliance with all code requirements.
The lollowing conditions shall be met during consvuction or ins[allation and prior to occupancy or use:
Ke�� Item(s)
• Comm ft?.40(3)(d)3. The installation of each RP. RP derector, PVB and SVB shall display a depanment
assigned identifica[ion number.
• -The backflow preventer shall be installed so that the relief valve oude[ is protec[ed by an approved air-gap.
The drain from the relief valve must discharge to either a Floor drain or an approved receptor. No part of[he
backflow preventer may be submerged under any circums[ance.
• - RP, PVB, or SVB's shall no[ be bq-passed. Escept for repair,they shall no[be made inoperative or removed
withuut departmental approval.
• Comm 8?.d I(5)(e). The floor drain or recepror ro receive Ihe discharge of the reduced pressure principle
backFlow preven[er relief vah�e shall be sized to handle the an[icipated discharge.
• - It is the responsfbiliry of Ihe owner ro make sure the device is tes[ed and ihat Ihe test report fomu(SBD-9927)
is sent to the Safety and Buildings Division upon completion of the test. A department-listed Backflow
Prevention Device Tester shall perform the rest A list of testers is available from the depanment upon request.
• -A TEST SHALL I3E CONDUCTED ON EACH RP.PVB, OR SVB PRIOR TO IT BEING PUT MTO
SERVICE, AND A MWIMUM OF ONCE A YEAR THEREAFT6R.
A copy of the approved plans, specitications and this letter shall be omsite during construction and open to
inspection by authorized representatives of d�e Depanment, which may include local inspectors. AII permi[s
�cyuir��J b� ihe statt or the local nuinicipality shull be obtained prior to commencement oC
cons�rucuun'instal la[ion/operation.
JEFFREY D OGDEN Page 2 6/4/02
In gran[ing this approval Ihe Division of Safety& Buildings reserves the right to require chan�es or addi[ions should
conditions arise making them necessaq� for code compliance. As per stare stats 10 L 12(2), nothing in [his review
shall relieve[he designer of ihe responsibility for desi�ning a saEe building, siruc[ure,or component.
Inquiries concerning this correspondence may be made to me at the telephone number lis[ed below,or a[ihe address
on this Ie[terhead.
Sincerely, Fee Required$ 125.00
Fee Received$ 125.00
��. ,,,;,��j � ���� Balance Due � 0.00
Herman J Delfosse
Plumbing Plan Reviewer? , Integrated Services bViSMART code� 7657
(608)789-5�35 . Mon -Thur 6:45 -4:30 Fri 6:45-10:4�
hdelfosse r commerecs�ate.�vi.us
cc: James E Zickert. Plumbing Consultant,(920)948-7336
A-C Compressor/Ge