HomeMy WebLinkAboutCross Connection (March 9, 00)��isconsin
Departmentof Commerce
IDiarch 09, 2000
CUST ID No.220229
ARNOLD F HENKE
1308 MARICOPA DR
OSHKOSH WI 54904
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PO BO% "/162
MADISON WI 53707-'lifi2
T00 �'. (608) 264-871]
}wnv commerrastate.wi.us
Tommy G. Thompaon, Covernor
BrenCa J. BlanchaN, SttreWry
A7TN: Plumbing INSPECTOR
MUN[C[PAL CLHRK
CITY OF OSHKOSH
PO BOY 1130
OSHKOSH WI 54902-1l30
RE: CONDITIOVpI,qPPROVAL
PLAN APPROVAL EXPIRES: D3109/2002 Ideutificarion Numbecs
Transaction ID Yo. 300295
Site ID Yo. 584936
STTE: Please refec to 6oth identification numbecs,
Si[e ID: 58493fi above, in all corres ondence with the a enc .
WNNEBAGO County, Ciry oCO5HKO5H; 35�0 MOSER ST, OSHKOSH 54901
Facility: BANNER PACKAGING 3550 MOSER ST, OSHKOSH 54901
FOR:
Descriptiou: SERVMG CROSS CANNPCTION WI7I3 WELL & CITY WA'CER
Object Type: Qoss Connec[ion Control Device RegWa[ed Object [D No.�. 650770
Device Type: Reduced Pressure Preventer, Loca[ion on Property: PRESS ROOM, MarmfacNrer: WATTS, Ylodel:
909M1, 2" Valve 5ize
The submittal described above has been ceviewed foc conformance with applicab(e Wisconsin Administrative Codes
and W[scousin Stamces. The subrtuttnl has been CONDIPIONALLY APPROVED. The owne�, as detined in
chaprec 101.01(10), W isconsiv Statutes, is cesponsible for wmpliance vnth al] code requfrements.
The foliowing eondi[ions shall be met during consttuc[ion or installanon and prior to occupancy or �se:
A TEST SHALL BE CONDUCTED 0\' BACH RP, PVB, OR SVS PRIOR TO IT BEIPG PUT INTO
SERV[CE AND A MIMNNM OF ONCE A YEAR THEREAFTER.
It is the responsi6itiry of Che owner ro make sure the device is res[ed and tlia[ th. test repoa fortns (SBD-9927) is
sent to the Safety and Buildings Division upon completion of the rest A departznenrAsred Backflow Pcecemion
Device Testrr shall prrtorm the rest A list of testers is availabfe &om the depamnent upon requcst.
RP, P V6, oc SlB's shali nat be by-passed. Except for repaie, they shall not be made inoperative or cemo�'ed
wi[hou[ depanmenml approval.
'Phe backflow prevenrec shall be us:allcd so t4at tlie ceficfvulve ou;(e[ is pmrected by vn approved oir-�_np- 11ie
d[ain from die relief valve mus[ discharge ro eithec a ftoor drain or an approved ceceptot No paR of the
backtlow preventer may be suhmerged under any cizcumstance.
Comm 82.4](6).7'he c�oss connection wntrol device shall be maintained and tested in accordance wi[h
82.21(3).
A copy of the approved plans, specifica[ions and @tis letter shall be on-site dunng conshuc[ion and open to
inspec[ion by authocized repcesenta[ives of the Deparhne�t, which may include local inspecto�s. AII pertni[s
required by the stace oe the local municipality shall be ob[ained prior to commencement of
codshuc[ior✓installa[ion/opera[ion.
ARNOID F HENKE
Page 2 J/9/00
Inquiries conceming this wrtespondence may be rtwde ro me at the telephoue uumbe� listed below, oc at the addcess
on this letterhead.
Sincer�/`1'/"` � /��
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RYAN M BOEeEL , PLUMBING PLAN REVIEWER
Integrated Secvices
(fi08)261-6535 , MONDAY-FRIDAY 0715-1600
RBOEBEL@COMMERCE.STATE.WI.US
cc: BANIYER PACKAGING
DATE RECE[VED 03/Ol/20i
FEE REQUIRED $ I 10.00
FEE RECEIVED $ I10.00
BALANCE DUE $ 0.00