HomeMy WebLinkAboutState Transaction ID #15535120
Safety and Buildings
2331 SAN LUIS PL STE 150
GREEN BAY WI 54304
TDD #: (608) 264-8777
www.commerce.wi.gov/sb/
www.vrisconsin.gov
Jim Doyle, Governor
Jack L. Fischer, A.I.A, Secretary
July 02, 2008
CUST ID No. 222086
EUGENE R SHUMANN
SHUMANN & ASSOCIATES INC
4433 MORMON COULEE RD
LA CROSSE WI 54601
ATTN.• Plumbing Inspector
MUNICIPAL CLERK
CITY OF OSHKOSH
PO BOX 1130
OSHKOSH WI 54903-1130
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 07/02/2010
Kwik Trip Store 741
215 West 20TH Avenue
City of Oshkosh, 54602
NE1/4, S35, T18NN 16E
FOR:
Facility: 690200 KWIK TRIP STORE 741 CAR WASH
215 WEST 20TH AVENUE
OSHKOSH 54602
Plan Type: New
Identification Numbers
Transaction ID No. 1553512
Site ID No. 736760
Please refer to both identification numbers,
above, in all cones ondence with the a enc .
Object Type: Water Reuse, Graywater Regulated Object ID No.: 1187992
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:
• 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.
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
EUGENE R SHUMANN Page 2 7/2/2008
appear on laboratory letterhead. 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 fmal 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 BODSi
• < 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.
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.
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 $ 120.00
Fee Received $ 120.00
Balance Due $ 0.00
WiSMART code: 7657
cc: James E Zickert, Plumbing Consultant, (920) 948-7336
Shumann & Associates Inc
Brad Fry, Kwik Trip Inc
EUGENE R SHUMANN Page 3 7/2/2008
Obiect Location: Date Maintenance
Transaction ID No. 1553512 Performed:
Kwik Trip Store 741 Site ID No. 736760 Next Scheduled
215 West 20TH Avenue Regulated Object No.: 11 87992 Maintenance:
City of Oshkosh, 54602
NE1/4, S35, T18NN, R16 Maintenance Cvcle:
^ 3 Months
^ 6 Months;
® 12 Months
Maintainer Water Source: Water Treatment Component(s):
Name: Device Backwash ®Reservoir
Address:
City: Reclaimed Water Use: The department reserves
State/Zip ^ Water Closets; ^ Urinals; the right to amend the
Phone: ^ Irrigation; ^ Hose Bibb; treatment standards as
®Other Under Bod Wash conditions arise to protect
Reauired Treatment Standards Sample Date the health and welfare of
< 6-9 pH Test Result the general public and the
< 10 mg/L Bods pH waters of the state.
< 5 mg/L TSS mg/L BodS
0 cfu fecal coliform/100 mL mg/L TSS Amendments:
cfu fecal coliform/100 mL
Component Maintenance
System operating within stipulations of approval: ^ Yes ^ No
Components installed as spec ified 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 Jim Zickert annually.
Mail to: Jim Zickert
PO Box 66
Eldorado, WI 54932