HomeMy WebLinkAboutCross Connection (trans id #224263) Safety and Buildings
1340 E GREEN BAY ST STE 300
SHAWANO WI 54166
TDD #: (608) 264 -8777
IsconsIn www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
May 17, 1999
CUST ID No.3783 4ITN: Plumbing INSPECTOR
HVAC
VALENTINE PLUMBING & HEATING INC CITY OF OSHKOSH
W2015 INDUSTRIAL DR PO BOX 1130
KAUKAUNA WI 54130 OSHKOSH WI 54902 -1130
RE: CONDITIONAL APPROVAL
APPROVAL EXPIRES: 05/17/2001 Identification Numbers
Transaction ID No. 224263
Site ID No. 11966
SITE Please refer to both identification numbers,
Site ID: 11966 I above, in all correspondence with the agency.
WINNEBAGO County, City of OSHKOSH; 3116 QUAIL RUN, OSHKOSH 54901
Facility: BRIGHTBILL 3116 QUAIL RUN, OSHKOSH 54901
FOR:
Description: Cross Connection for Turf Sprinklers
Object Type: Cross Connection Control Device Regulated Object ID No.: 466647
Device Type: Pressure Vacuum Breaker, Manufacturer: WATTS, Model: 800, 1" Valve Size,
Location:West side of the house
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:
A COPY OF THE APPROVAL LETTER MUST REMAIN ATTACHED TO THE PLAN.
- A TEST SHALL BE CONDUCTED ON EACH REDUCED PRESSURE PRINCIPLE BACKFLOW
PREVENTER PRIOR TO IT BEING PUT INTO SERVICE, AND A MINIMUM OF ONCE A YEAR
THEREAFTER.
- It is the responsibility of the ow ner to ma stire 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 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.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.