HomeMy WebLinkAboutCross Connection Control Assembly
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Jim Doyle, Governor
Mary P. Burke, Secretary
August 21,2007
CUST 10 No. 225314
PATRICK R BERTRAM
AHERN GROSS INC
218 S MAIN ST
PO BOX 1027
FOND DU LAC WI 54936-1027
JILL MCEWEN
FOX VALLEY TECHNICAL COLLEGE
3729 SOUTH OREGON ST
OSHKOSH WI 54903
CROSS CONNECTION CONTROL ASSEMBLY
REGISTRATION
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Transaction 10 No. 1433221
Site 10 No. 723004
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SITE:
Fox Valley Technical College
3729 Oregon St
City of Oshkosh
FOR:
Facility: 678671 FOX VALLEY TECHNICAL COLLEGE FABCO CENTER
3729 OREGON ST
Object Type: Cross Connection Control Device Regulated Object 10 No.: 1148402'
Device is Serving: Pressure Washer; Device Type: Reduced Pressure Preventer; Location on Property: Am
201 - Mezzanine; Manufacturer: WATTS; Model: 909QT;Serial No.: 618523; 3/4" Valve Size
Object Type: Cross Connection Control Device Regulated Object 10 No.: 1148403
Device is Serving: Parts Washer; Device Type: Reduced Pressure preventer; Location on Property: Rm 116
- Diesel Lab; Manufacturer: WATTS; Model: 909QT; Serial No.: 618525; 3/4" Valve Size .
Per your request the device(s) described above has been REGISTERED with our agency, in lieu of plan
review by our agency. As owner of this building, you should understand:
1. That there will be no review of the installation plans for this project conducted by the Department of
Commerce.
2. That there will be no routine inspections conducted by the Department of Commerce during the
installation of this project.
3. That plan review and/or inspections by the local municipality may be required by local permitting
ordinances.
4. That this registration does not affect the requirements to submit plans for building systems, plumbing
systems, private sewage systems, swimming pools, elevators or other plans if applicable.
5. That upon completion of construction, this installation shall be in compliance with all applicable
Wisconsin codes and standards.
6. That as the owner, you are responsible to assure that a performance test is conducted for the above
assemblies at the time of installation, immediately after repairs or alteration to the assembly andat
least annually.
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Page 2
8/21/2007
8. No person may engage in or work at plumbing in the state unless licensed to do so by the department
per s.145.06 stats.
Prior to the start of construction, all applicable plumbing permits should be obtained from the authorities
having jurisdiction in accordance with local laws and ordinances. This registration is valid for the period
indicated above. Thereafter, the unfinished portions of the project shall be redesigned to the code existing
at that time and shall be re-registered with our agency.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at
the address on this letterhead. Please refer to the Transaction 10 No. referred to in the regarding line
when making an inquiry or submitting additional information. ..
;LdU~
Anna Beck
License/Permit prog Associate, Integrated Services
(920) 492-5602, Fax: (920) 492-5604 , Tuesday - Friday 8 am -
4:30 pm .
anna.beck@wisconsin.gov
cc: Municipal Clerk City of Oshkosh, 910/236~5011