HomeMy WebLinkAbout20589 - Cross connections (01/04/13) CITY OF OSHKOSH INSPECTION SERVICES DIVISION ROOM 205
215 CHURCH AVE DEPARTMENT OF COMMUNITY DEVELOPMENT
PO Box 1130 OSHKOSH
OSHKOSH WI 54903-1130 CORRECTION NOTICE
ON THE WATER
Issue Date 1/4/2013 Re Issue Date 2/6/2013 Complies No
Address 870 W SOUTH PARK AVE
Sent to 0 Owner POKLASNY INC 870 W SOUTH PARK AVE OSHKOSH WI 54902 -6366
Required for Occupancy Occupancy
Introduction Notification of your correction(s)to the violation(s)cited on the recently conducted cross connection control survey has not
been received.
Item# 1 Code SPS 38241(3) Complies No Comply By 03/08/2013 IMMEDIATELY
Description Water supply systems and the connection of each plumbing fixture, piece of equipment, appliance or nonpotable water piping
system shall be designed, installed and maintained in such a manner to prevent the contamination of water supplies by means
of cross connections.
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Violations must be corrected and approved by the noted compliance dates of each item. Call for reinspections prior to concealment
and/or occupancy. Upon completing the corrections,the owner/contractor/agent must sign and date at the bottom of this notice
and return it to the Inspection Services Division by the Compliance Date of 2/313 -/S-/3
Office hours are Monday through Friday 7:30 a.m. -4:30 p.m. or by appointment. To schedule inspections please call the Inspection
Request line -t 23 5128 noting the address, permit number(when applicable),and the nature of what needs to be inspected.
Signature 41„iip/m,aw Date e::2—&—I.3
Inspected by: Jon Mueller 236-5049 jmueller @ci.oshkosh.wi.us
I hereby certify the violations listed on this report have been corrected in compliance with the applicable codes.
Print Name Company
Signature Date
Also Sent to: J Bldg
J Elec — —
J HVAC
Plbg
Designer
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- --------
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J Other
J Inspector
CIO FINAL
NOTICE
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