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HomeMy WebLinkAbout2008-Plumbing (RPZ valve)OSHKOSH ON THE WATER Job Address 2400 S WASHBURN ST Contractor ACTION PLUMBING Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater Site Drain Roof Drain Misc. Fixtures Use/Nature of Work No 131961 Create Date 03/14/2008 Plan Shower Water Softner ~I Wait. St. Shamp Sink Coffee Maker Floor Drain Local Waste Ice Chest FlrMlst Sink Int Grease Trap Lndry Tray Clothes Wshr Exam Sink Catch Basin Ext Grease Trap Disposal Bidet Sculry Sink Wash Ftn RPZ Valve 1 Dishwasher Beer Tap I Hand Sink Urinal Eye Wash Statn Sump Pump Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs Classrm Sink Sterilizer Surgeons Sink Ice Maker Deduct Meters Breakrm Sink Dip Well ', F Prep Sink Gar Drain Wtr Usage Mtrs Ejector/Grind Drink Ftn Serv Sink Soda Disp Valuation $475.00 Plan Approval $0.00 'Permit Fees $25.00 ^ Permit Voided Issued By i Date 07/31/2008 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement holder(s) and to secure any necessary approvals before starting such activity. Signature li Date Agent/Owner Address 149 CAUSEWAY BLVD LA CROSSE WI 54603 - 3151 Telephone Number (608) 784-2233 ~ o scneawe inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may continue if the inspection is not performed within two business days from the time the project is ready. II CITY OF OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD Owner C S I WI LTD PRTSP Category 440 -Industrial-Interior citJul, 28:,~2Q08 12;22PM Cnspection Services Division P 0 Bax 1130 Oshkosh, WI 54903-1 I30 Phone: (920) 236-5054 Fax:{920)236-5484 No, 2796~,,P. 1/1 Hi~C~ ON THE ATf~R Plumbing Permit Application I hereby apply for a permit to do end install the following pltumbing on the premises hereinafter dtseribed, the work to conform tp the '~Yisconsin State Plumbing Cade, in the performance of which all parties hereto agree to and are bound by said statutes. * Applicatian(s}and fee(s) can be brought to~City PTall, Rabm 205 or mailed to Irlspeation Services, pQ I3px 1128, Oshkosh WI 54903-1128, Commencing work without permit(s) will; result in fees being doubled or X104.44 plus the normal permit fee, which ever is greater. OR ij you want thts processed through oy ur ac~unt' I I ** Adrisory~ • For applicable Irojects, ari $lectrical Tnstallattion Verification ($I1~ dorm, signed by the Electrical Contractorr or homeowner (,For installations allowed to be peltform,ed by the hameownor) moist be submitted with the pernnit application. Applications submitted without tint ~rV when such is required, will not be processed For Permit Issuance and will be returned for cvtnpletion. ~ ,)Cob Address '" ~ Value (Including labor and matertatsl . a~ Date ~ L I~, Qwvn er Contractor G/ic~+ Sin le P'amil Du ~ [] g y p ^Multi-Famfly ^l~ental ~Commcr al Industrial Number of Fixtures: Bathtub Disposal Whirtp~l Dishwasher l.avalory Sump Pump Toilet .~,._, ~EjeolorlGrind Res. Sink Water 5oftner Sar Sink LOCaI Waslc Water Heater Clashes Wshr D t3as f3 Elect Q PwrVM f3idN Shower Heer't'ap FI©or Drain ~ Classrm Sink Lndry Thy Surgeons Sink l.elb Sink Breakim Sink plaster Sink Dip Well _,,,~_, 5teriliur ,,..~ Hoso Sibs Mise. ~ _ Fh ~ ~ f~ crures 1~lectric Contractor (fa r projects not requiring an ] Use /Nature of Work .-~~_~f~~! _ .~' //„~ ~~ Size Sanitary Sewer Storm Sewer Water Service Drink ptn .._ GatGh Basin Wait. Sl. Wash Fin 1Ce Chest Urinal Exam Sink Gar Drain Sav)ry Sink Soda Disp Hand Sink ~.., Coffee Maker F Prep Siak Comm, iCC Mstku Serv Sink ~SMa lure ]nt Grease Trap '~ g~a~ ~m ~~ &xt 4rcasa Trap 5landp l€cc R.p.2.'Valva -~U~ 3 1 ~tRresl, Stn Shame Sink r ~ ,, ~ t wet Mtrs -$EPA,t , a ii~v~ t.. ; Flr/WstSink Cp~,~;'~'~? ir?;ldpiittd~ INSPECTION S~i:~yl~~ichWsag`dlvNF~i+~ ~,~„ Form) .~ # ~ Conn. Type ~~ o~~o~ commerce.wi.gov isconsin Department of Commerce OCT 9 2008 Safety and Buildings 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304 Contact Through Relay www.commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor t:`r''f_a,; i~`ai~ll Oi= Richard J. Leinenkugel, Secretary C01~1NEJ1`~Ii'~ :>'~Vhs»~~~'f~ll~f~l INSPECT IC~~i SEi~l,~ICI:.S ~I~/iclOf~ October 06, 2008 CUST ID No. 222086 EUGENE R SHUMANN SHUMANN & ASSOCIATES INC 4433 MORMON COULEE RD LA CROSSE WI 54601 CONDTTIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/06/2010 SITE: Kwik Trip Stores #457 2400 S Washburn St City of Oshkosh, 54901 FOR: Facility: 674301 KWIK TRIP STORES #457 CAR WASH 2400 S WASHBURN ST OSHKOSH 54901 Plan Type: Addition-Alteration ATIN: Plumbing Inspector MUNICIPAL CLERK CITY OF OSHKOSH PO BOX 1130 OSHKOSH WI 54903-1130 Identification Numbers Transaction ID No. 1592410 Site ID No. 715107 Please refer to both-identification numbers, above, in all cones ondence with the a enc . Object Type: Water Reuse, Graywater Regulated Object ID No.: 1201698 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. 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. ' The following conditions shall be met during construction or installation and prior to occupancy or use: The following conditions shall be met during construction or installation and prior to occupancy or use: • A roueh-in and Iinal insaection is required. When the installation is ready for either of these inspections, the registered architect, professional engineer or plumbing contractor constructing or modifying the reuse system shall make a telephone request for inspection to the Plumbing Consultant shown at the bottom of this letter. Data collection and reporting shall occur on an annual basis. The samples shall be collected while the system is operating. The minimum data collected and reported shall consist of the following: 1. pH; 2. BODS (Biological oxygen demand, 5 day) 3. Total suspended solids (TSS); 4. Fecal coliform per 100 ml; 5. Color; 6. Odor; A water sample shall be taken and tested at the initial startup. Additional water tests and maintenance reports shall be conducted every 12 months after the initial testing. All testing must be conducted in accordance with "Standard Methods for the Examination of Water and Wastewater" current edition or EPA methods. This data must be officially reported to this department by a Wisconsin registered Architect, Engineer or licensed Master Plumber who's directly overseeing the installation and maintenance of the ~aa;q ~~'{ v .': ~ u. ~a... EUGENE R SHUMANN Page 2 10/6/2008 system. Maintenance of components shall be according the manufacturer's recommendations. The test reports must be submitted to the Wisconsin State Plumbing Consultant listed below. The test report must appear on laboratory letterhead and be accompanied by a $25.00 filing fee. If the requested data is not submitted on a timely basis, the system will be ordered shut down and removed and the associated plan approval shall immediately be rendered null and void. • The final effluent from this system may only be used for the following specific end uses: UNDER BODY WASH, provided the minimum water quality treatment standards listed below are achieved: • < 6-9 pH • < 10 mg/L BODS; • < 5 mg/L TSS • 0 cfu fecal coliform/100mL Key Items • Item 1. Label receptor for reuse water system only • Item 2. Label nonpotable water system per 82.40(d)1. • Item 3. Water distribution pipe shall conform to one of the standards listed in Table 84.30-8. The water supply system shall be resistive to corrosive action and degrading action from the water being conveyed. • Item 4. All materials in contact with water, shall be suitable for use with potable water. • Item 5. The reuse water tank shall be water tight per 84.25(2), and constructed per 84.25(3). Access shall be provided per 84.25(7). Openings larger than 8 inches shall be provided with locking devices and labels to identify the use. The system performance is based on expectations of the water treatment components submitted for review. This department approval recognizes the potential of the components to achieve the minimum water quality standards listed in Comm Table 82.70 for the specific use of this water, but does not guaranty the compliance with the listed standards. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & 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 concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincere ho asr B un Plumbing Consultant ,Integrated Services (715) 340-5387, Fax: (715) 345-5269 ,Mon. 7:45-4:30 tbraun @ commerce. state. wi . u s Fee Required $ 120.00 Fee Received $ 120.00 Balance Due $ 0.00 iSMART code: 7657 cc: Thomas L Braun, Plumbing Consultant, (715) 340-5387 ,Mon. 7:45-4:30 Thomas Braun, Plumbing Consultant, (715) 340-5387 Shumann & Associates Inc Brad Fry, Kwik Trip Inc EUGENE R SHUMANN Page 3 10/6/2008 Owner Object Location: Date Maintenance Kwik Trip Inc Transaction ID No. 1592410 Performed: Brad Fry Facility: 674301 KWIK TRIPS Site ID No. 715107 Next Scheduled 1626 Oak #457 CAR WASH Regulated Object No.: Maintenance: PO Box 2107 2400 S WASHBURN ST 1201698 LaCrosse WI 54602 , . - 2107 OSHKOSH 54901 Maintenance Cvcle: 608-793-6414 ^ 3 Months ' ^ 6 Months; ® 12 Months Maintainer Water Source: Reject water from RO Component(s): Name: S stem Cistern Address: Reclaimed Water Use: The department reserves City: ~ Underbody Vehicle Wash the right to amend the State/Zip treatment standards as Phone: conditions arise to protect Required Treatment Standards Sample Date the health and welfare of < 6-9 pH < 10 mg/L Bods Test Resuit PH the general public and the < 5 mg/L TSS mg/L Bods. waters of the state. 0 cfu fecal coliform/100 mL mg/L TSS cfu fecal coliform/100 mL Amendments: Component Maintenance System operating within stipulations of approval: ^ Yes ^ No Components installed as specified in Approved Plan: ^ Yes ^ No Components being maintained as per manufacturer's recommendations: ^ Yes ^ No Maintainer: Name: I certify this is a true and accurate report of Wisconsin Credential: my inspection. Signature & Date REMARKS: This form is to be completed and sent to annually. Mail to: Tom Braun PO Box 11 Waupaca, WI 54981 commerce.wi.gov isconsin Department of Commerce Safety and Buildings 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304 Contact Through Relay www. commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary October 06, 2008 CUST ID No. 222086 EUGENE R SHUMANN SHUMANN & ASSOCIATES INC 4433 MORMON COULEE RD LA CROSSE WI 54601 ATTN: Plumbing lnspector MUNICIPAL CLERK CITY OF OSHKOSH PO BOX 1 130 OSHKOSH WI 54903-1130 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/06/2010 SITE: Kwik Trip Stores #457 2400 S Washburn St City of Oshkosh, 54901 FOR: Facility: 674301 KWIK TRIP STORES #457 CAR WASH 2400 S WASHBURN ST OSHKOSH 54901 Plan Type: Addition-Alteration Identification Numbers Transaction ID No. 1592410 Site ID No. 715107 Please refer to-:both identification numbers, above, in all correspondence with the Object Type: Water Reuse, Graywater Regulated Object ID No.: 1201698 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. 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. The following conditions shall be met during construction or installation and prior to occupancy or use: The following conditions shall be met during construction or installation and prior to occupancy or use: • A rough-in and final inspection is required. When the installation is ready for either of these inspections, the registered architect, professional engineer or plumbing contractor constructing or modifying the reuse system shall make a telephone request for inspection to the Plumbing Consultant shown at the bottom of this letter. EUGENE R SHUMANN Page 2 10/6/2008 • Data collection and reporting shall occur on an annual basis. The samples shall be collected while the system is operating. The minimum data collected and reported shall consist of the following: 1. pH; 2. BODS (Biological oxygen demand, 5 day) 3. Total suspended solids (TSS); 4. Fecal coliform per 100 ml; 5. Color; 6. Odor; A water sample shall be taken and tested at the initial startup. Additional water tests and maintenance reports shall be conducted every 12 months after the initial testing. All testing must be conducted in accordance with "Standard Methods for the Examination of Water and Wastewater" current edition or EPA methods. This data must be officially reported to this department by a Wisconsin registered Architect, Engineer or licensed Master Plumber who's directly overseeing the installation and maintenance of the system. Maintenance of components shall be according the manufacturer's recommendations. The test reports must be submitted to the Wisconsin State Plumbing Consultant listed below. The test report must appear on laboratory letterhead and be accompanied by a $25.00 filing fee. If the requested data is not submitted on a timely basis, the system will be ordered shut down and removed and the associated plan approval shall immediately be rendered null and void. • The final effluent from this system may only be used for the following specific end uses: UNDER BODY WASH, provided the minimum water quality treatment standards listed below are achieved: • < 6-9 pH • < 10 mg/L BODS; • < 5 mg/L TSS • 0 cfu fecal coliform/100mL Key Items • Item 1. Label receptor for reuse water system only • Item 2. Label nonpotable water system per 82.40(d)1. • Item 3. Water distribution pipe shall conform to one of the standards listed in Table 84.30-8. The water supply system shall be resistive to corrosive action and degrading action from the water being conveyed. • Item 4. All materials in contact with water, shall be suitable for use with potable water. • Item 5. The reuse water tank shall be water tight per 84.25(2), and constructed per 84.25(31. Access shall be provided per 84.25(7). Openings larger than 8 inches shall be provided with locking devices and labels to identify the use. EUGENE R SHUMANN Page 3 10/6/2008 The system performance is based on expectations of the water treatment components submitted for review. This department approval recognizes the potential of the components to achieve the minimum water quality standards listed in Comm Table 82.70 for the specific use of this water, but does not guaranty the compliance with the listed standards. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(21, nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Thomas L Braun Plumbing Consultant ,Integrated Services (715) 340-5387, Fax: (715) 345-5269 ,Mon. 7:45- 4:30 tbraun@commerce.state.wi.us Fee Required S 120.00 Fee Received S 120.00 Balance Due S 0.00 WiSMART code: 7657 cc: Thomas L Braun, Plumbing Consultant, (715) 340-5387 ,Mon. 7:45-4:30 Thomas Braun, Plumbing Consultant, 1715) 340-5387 Shumann & Associates Inc Brad Fry, Kwik Trip Inc EUGENE R SHUMANN Page 4 10/6/2008 Owner Obiect Location: Date Maintenance Kwik Trip Inc Transaction ID No. Performed: Brad Fry Facility: 674301 KWIK 1592410 Next Scheduled 1626 Oak STORES #457 CAR W Site ID No. 715107 Maintenance: PO Box 2107 2400 S WASHBURN S Regulated Object No.: LaCrosse, WI. OSHKOSH 54901 1201698 54602-2107 Maintenance Cycle: 608-793-6414 ^ 3 Months ^ 6 Months; ® 12 Months Maintainer Water Source: Reject water from RO Component(s): Name: S stem Cistern Address: Reclaimed Water Use: The department reserves City: ®Underbody Vehicle Wash the right to amend the State/Zip treatment standards as Phone: conditions arise to protect Required Treatment Sample Date the health and welfare of Standards Test Result the general public and the < 6-9 pH pH waters of the state. < 10 mg/L Body mg/L Body < 5 mg/L TSS mg/L TSS Amendments: 0 cfu fecal coliform/100 mL cfu fecal coliform/100 mL Component Maintenance System operating within stipulations of approval: ^ Yes ^ No Components installed as specified in Approved Plan: ^ Yes ^ No Components being maintained as per manufacturer's recommendations: ^ Yes ^ No Maintainer: Name: I certify this is a true and accurate report of Wisconsin Credential: my inspection. Signature & Date REMARKS: This form is to be completed and sent to annually. Mail to: Tom Braun PO Box 11 Waupaca, WI 54981