HomeMy WebLinkAbout21941-Cross Connection Control (survey) 12/27/2013 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 12/27/2013 Re Issue Date Complies No
Address 1300 SOUTH DR
Sent to ✓ Owner ' WINNEBAGO MENTAL HEALTH INSTITI PO BOX 9 WINNEBAGO WI 54985 -0009
Required for Occupancy� Occupancy
Introduction Notification of your correction(s)to the violation(s)cited on the recently conducted cross connection controi survey has not
been received.
Item# 1_ Code SPS 382.41(3) _ Complies No _ Comply By 01/26/2014 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.
Summarv Please make arrangements to correct these violations immediately. Please report the corrections to the Plumbing Inspector
(920)236-5049 M-F 8:00-4:30 so that a follow-up inspection may be scheduled.
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 1/26/2014
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 at 2 6-5128 noting the address, permit number(when applicable),and the nature of what needs to be inspected.
Signature Date �i�p?7(3
Inspected by: Jon Mue�ler 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: Bldg _
Elec , --- — -- —_
HVAC ,I — -- ----- -- -- -- -- — -_--
Plbg � -- —- — -- -- — _--
Designer _
Other , — - — --- _--
Inspector J — -- --- -- —
21941 Page 1 of 1