HomeMy WebLinkAbout2002-Cross Connection (trans id#822278) Safety and Buildings
401 PILOT CT STE C
WAUKESHA WI 53188 -2439
www.o
,SCOfSiI fl TDD #: (608) 284 -8777
anmeroe.state.wi.us/sb
Department of Commerce www•wisoonsin•gov
Scott McCallum, Governor
Philip Edw. Albert, Secretary
December 20, 2002
CUST ID No.232866 ATTN Plumbing Inspector -
RICHARD A BIESE MUNICIPAL CLERK
TT SCHMIDT PLUMBING INC CITY OF OSHKOSH
419 S WASHINGTON ST PO BOX 1130
COMBINED LOCKS WI 54113 OSHKOSH WI 54903 -1130
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 12/20/2004 Identification Numbers
Transaction ID No. 822278
SITE: Site ID No. 643853
Evco Plastics Please refer to both identification numbers,
max.
450 West Ripple Ave above, in all correspondence with the agen+y:';
City of Oshkosh, 54902 -8807
Winnebago County
FOR:
Description: Serving Cistern
Object Type: Cross Connection Control Device Regulated Object ID No.: 885406
Device Type: Reduced Pressure Preventer; Location On Property: Ne Corner of Building; Manufacturer: Watts;
Model: 909; Plan Type: Alteration; 3/4" 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 Items
1. Comm 82.41(5)(e)3.a. If an Rp is located within a building, a drain or approved receptor shall be
provided to receive the vent port discharge. The floor drain or receptor to receive the discharge of the
reduced pressure principle backflow preventer relief valve shall be sized to handle the anticipated
discharge.
2. Comm 82.40(3)(d)3. The installation of each RP, RP detector, PVB and SVB shall display a department
assigned identification number.
3. 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.
4. RP, PVB, or SVB's shall not be by- passed. Except for repair, they shall not be made inoperative or
removed without departmental approval.
5. 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.
6. 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.
RICHARD A BIESE Page 2 12/20/02
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, Fee Required $ 125.00
0Fee Received $ 125.00
Balance Due $ 0.00
Chet Kintop
General Plumbing Plan Reviewer , Integrated Services W
(262) 548 -8634, Fax: (262) 548 -8614 , Monday - Friday 07:45 To 4:30
ckintop @commerce.state.wi.us
cc: James E Zickert , Plumbing Consultant, (920) 948 -7336
Evco Plastics