HomeMy WebLinkAboutCross Connection - 11/14/2002 I r v Ir
Safety and Buildings
2331 SAN LUIS PL STE 150
i i I GREEN BAY WI 54304
1 002 TDD (608) 264 -8777
ISCOfl5In f www.commerce.state.wi.us /sb
Department of Commerce 1 1
I www.wisconsin.gov
CITY CLERK'S OF ICE Scott McCallum, Governor
Philip Edw. Albert, Secretary
November 14, 2002
CUST ID No.223215 ATTN:• Plumbing Inspector
MUNICIPAL CLERK
JAY R MERRILL CITY OF OSHKOSH
804 WITZEL AVE PO BOX 1130
OSHKOSH WI 54901 OSHKOSH WI 54903 -1130
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 11/14/2004 Identification Numbers
Transaction ID No. 804190
SITE Site ID No. 585326
Fox Valley Heat Treat Please refer to both identification numbers,
2601 Badger Ave above, in all correspondence with the agency.
City of Oshkosh, 54904
Winnebago County
FOR:
Description: 1" Watts 009 -Qt Rppbp Serving Process Tanks
Object Type: Cross Connection Control Device Regulated Object ID No.: 878935
Device Type: Reduced Pressure Preventer; Location On Property: East Wall Mfg Area; Manufacturer: Watts; Model:
009; Plan Type: Alteration; 1" 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 construction or installation and prior to occupancy or use:
Key Item(s)
#1. Comm 82.40(3)(d)3. The installation of each RP, RP detector, PVB and SVB shall display a department
assigned identification number.
#2. Install assembly per Comm 82.41 (5)(f).
Also Address
It is the responsibility of the owner to make sure the device is tested and that the test report forms
(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 test. A list of testers is available from the
department upon request.
A TEST SHALL BE CONDUCTED ON EACH RP,PVB, OR SVB PRIOR TO IT BEING PUT INTO
SERVICE, AND A MINIMUM OF ONCE A YEAR THEREAFTER.
The backflow preventer shall be installed so that the relief valve outlet is protected 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 the backflow preventer may be submerged under any circumstance.
RP, PVB, or SVB's shall not be by- passed. Except for repair, they shall not be made inoperative or
removed without departmental approval.
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
JAY R MERRILL Page 2 11/14/02
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, Fee Required 125.00
Fee Received 125.00
C Balance Due 0.00
Wesley C be
Plumbing Plan Reviewer Integrated Services WiSMART code: 7657
(920)492 -5613 M -R 7:00 16:30, F 7:00 11:00
wgrube @commerce.state.wi.us
cc: E C Merrill Inc
James E Zickert Plumbing Consultant, (920) 948 -7336
Fox Valley Heat Treat Inc