2006-06-16 Community Center Cross Connection Control Device Performance Test
.lJi'v
Cross Connec~on Control Device
Performance Test
RECEIVED
JUN 1 6 2006
Building Inspections
~
INITIAL TEST
1st check ~
[jCIOSed tight ~ CIo~ tight '.
o Leaked 0 Leaked
Static" .~. <1 Static '.'"
i=i.NAL.TEST..............................................,................................................................
[AI Closed tight ClI Closed tight
Static ~ , <1 Static ~. ,
DETECTOR BYPASS ASSEMBLY INITIAL TEST
[] ~~:~ti9ht
o Leaked
Static
RP relief valve .
Opened at 3. 1
o Did not open
PSID'.
PSID
PSID
DETECTOR BYPASS ASSEMBLY FINAL TEST
o Closed tight 0 Closed tight
S~ic Sta~
Opened at.
PRESSURE VACUUM BREAKER INITIAL TEST
Check valve
o Closed tight
o Leaked
Static PSID
Time of Day 't: Ie I'ItI
Date ~..t;l-CG::.
Yellow - Purveyor Copy
Pink - Tester Copy ,
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HM Services
7100 Madison Ave. W.
Golden Valley, MN 55427
763-746-8120
Cross Conndetion Control Device
Performance Test
RECEIVED
JUN 1 6 2006
o RP OetectorD oeD PVB/SVB
Ifi ;:':; tight
o Leaked
Static ?# ~. PSID
RP relief valve
Opened at .;I. I 'pSID
D Did not open
................'........._,...............'...................'.....~....'..........,..... ...~..,......,.........u...................................,..u.....,..:..............
FINAL tEST
IMJ Closed tight
Stlmc ., ,0
DETECTOR BYPASS ASSEMBLY INITIAL rEST
D~~;~~tight 6' t O;:~ti9ht
o Leaked 0 L~ked
Static Static . PSID
Opened at .:1./
PSID
RP re~ef valve
Opened at
o Did not open
DETECTOR BYPASS ASSEMBLY FINAL TEST
o Closed tight .0 Close4 tight .
. Static Static PSID
PRESSURE VACUUM BREAKER INITIAL TEST
Deck valve
.~ Closed tight
o Leaked.
Static
Air inlet valve
Opened at
PSID
PSID
II b t\ fl...
White - State Copy Yellow. Purveyor Copy
Pink - Tester Copy. . Goldenrod . Owner Copy
. '.
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ft;/~ - 5~J- 0909.
June 22, 2005
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Valley Plumbing Company, Inc.
860 Quaker Avenue
Jordan, Minnesota 55352
GentlernenlLadies:
Subject: Plumbing for Town Centre Community Center. Albertville, Wright County, Minnesota,
Plan No. 054197
Our office will not be issuing plan approval for the above-referenced project as it has come to our attention
that the plumbing system has already been installed. We do, however, note the following regarding
compliance with Minnesota Rilles, Chapter 4715:
1. Assuming a maximum developed length of pipe of 60 feet and a building water pressure at the meter
between 46 and 60 psi, and using Minnesota Rules, part 4715.3800:
a. The building supply line must be at least Iv.. inches in size between the meter and the first cold
water distribution branch connection downstream of the water heater.
b. The continuation of the building supply line must be at least I-inch in size up to the branch serving
the women's showers and lavatories.
c. The cold water distribution branch serving two water closets must be at least %-inch in size.
2.
-existing
3.
4.
=
p
'7'1-and F876.
~
-
General Information: (651) 215-5800 · TDD/TYY: (651) 215-8980 · Minne,ota Relay Service: (800) 627-3529 . www.health.state.11tttiiS
For directions to any of the MDH locations, call (651) 215-5800 . An equal opportunity employer
.
Valley Plumbing Company, Inc.
Miscellaneous
Plan No. 054197
Page 2
June 22, 2005
!Jar. J' ct", 'i Pvl .. ~ e..--
b. The system must be installed by a pfumber trained by the manufacturer of the particular PEX system
to be installed. Certain manufacturers require installation by licensed plumbers who have been
trained to install their material.
c. All persons installing PEX materials shall have a card on their possession documenting completion
of training by the manufacturer or.his agent for the material to be installed.
d. The tubing and fittings must be marked as required by the applicable standard specification and with
the appropriate ASTM designations by the manufacturer.
e. The installation must be in accordance with the manufacturer's installation guidelines.
5.
""6.
te
(}.
7. The water piping system shall be disiufected in accordance with Minnesota Rwes, part 4715.2250.
Upon completion/verification of these items, please contact Mr. Charles Olson at 651/215-0856 for a
plumbing inspection. If you have any questions, please contact me at 651/215-0853.
Sincerely,
r-7? /t" /:CL-
~-~"
Bradley C. Erickson
Public Health Engineer
Environmental Health Services Section
P.O. Box 64975
St. Paw, Minnesota 55164-0975
BCE:sas
cc: City of Albertville
Charles Olson
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CITY OF ALBERTVILLE
INSPECTION NOTICE
M T @TH F
SCHEDULED 51 nlo'?
\N tJtK,ewLmtG- 11me
PHONE
PHONE
o MECHANICAL FINAL 0 SITE INSPECTION
o FIREPLACE AT THROAT 0 GRADING/EXCAV.
o FIREPLACE FINAL 0 COMPLAINT
o INSULATION 0 FOLLOW-UP
o DEMOLITION 0
o FINAL 0
~?z., -.p~ '7-0:pJ;? tl
PERMIT NO.
e ADDRESS '- \ -ry-'7t\
~ OWNER
ti!i CONTRACTOR
~ 0 FOOTINGS
i!: 0 FOUNDATION
~ 0 DRAIN TILE J
LU ~LUMBING""I
3 0 PLUMBING FINAL
~ 0 MECHANICAL RI
o
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ffi
Cl.
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62 - RtC P'~ J)~AL (Alio
t?k~ ~. (C/1D#7If/lf;~
WORK SATISFACTORY: PROCEED.
o CORRECT WORK & PROCEED.
~ 0 CORRECT WORK & CALL FOR RE-INSPECTION BEFORE COVERING.
IJ.J 0 CORRECT UNSAFE CONDITION IMMEDIATELY
o STOP ORDER POSTED. CALL INSPECTOR.
8 0 INSPECTION REQUIRED. CALL TO ARRANGE ACCESS.
o PHOTO TAKEN
Call Bldg. Depl. at 763-497-5106 at least 24 hours in advance for an appointment.
Owner/Contractoron ,e ~
Inspector <:: ct.
City of Albertville, 5975 Main Avenue NE, Albertville, MN 55301
Phone: 763-497-5106 Fax 763-497-2068
White Copy!lnspecto(s Files
Yellow Copy! Site Notice
June 22, 2005
L J ,; 2 4 Z005
DEPARTMENT OF HEALTH Building Ins
1>.. . ... __J' . th bulb ,/.'_11 M' peCtiOns
n'otectm~ mamtaznmg ana WlpTovmg e eat~ OJ aummnesotans
~(1.,1tOS
I-I\~'SAM- 'tV &f&~t0
q S'L-4q~~-Uzl
RECEK'VEn
Valley Plmnbing Company, Inc. .--
860 Quaker Avenue "..-
Jordan, Minnesota 55352
~
$,
GentlemenlLadies:
Subject: Plumbing for Town Centre Commnnity Center, Albertville. Wright County, Minnesota,
Plan No. 054197
Our office will not be issuing pIan approval for the above-referenced project as it has come to our attention
that the plmnbing system has already been installed. We do, however, note the following regarding
compliance with Minnesota Rules, Chapter 4715: .
I. Assuming a maximum developed length of pipe of 60 feet and a building water pressure at the meter
between 46 and 60 psi, and using Milinesota Rules, part 4715.3800:
a. The building supply line must be at least 114 inches in size between the meter and the first cold
water distribution branch connection downstream of the water heater.
b. The continuation of the building supply line must be at least I-inch in size up to the branch serving
the women's showers and lavatories.
c. The cold water distribution branch serving two water closets must be at least o/.o-inch in size.
2. The installation of reduced pressure zone backflow preventers is permitted only when periodic testing is
done by a trained backflow preventer tester acceptable to the administrative authority. Testing intervals
shall not exceed one year, and records must be kept. All devices must be tested after initial installation
to assure that debris from the piping installation has not interfered with the functiouing of the device.
The devices shall be overhauled at least once every five years. The installation of new backflow
preventers must be at least 12 inches, but not more than 6 feet above the finished floor or ground level.
3. It is recommended that a cleanout be provided where new waste and vent piping connects with existing
plmnbing to facilitate required testing of the new installation.
4. The installation of a cross-link polyethylene (PBX) tubing system was specified for the water
distribution system. If all of the following requirements cannot be met, the materials used for the water
distribution system must comply with Minnesota Rules, part 4715.0520:
a. The system must comply with ASTM Standard F877 and F876.
General Information: (651) 215-5800 · TDD/TYY: (651) 215-8980 · Minnesota Relay Service: (800) 627-35.29 · www.bealth.state.mn.us
For directions to any of the MDH locatious, call (651) 215-5800 . An equal opportunity employer
Valley Plumbing Company, Inc.
Miscellaneous
Plan No. 054197
Page 2
June 22, 2005
b. The system must be installed by a plumber trained by the manufacturer of the particular PBX system
to be installed. Certain manufacturers require installation by licensed plumbers who have been
trained to install. their material.
c. All persons installing PBX materials shall have a card on thei,r possession documenting completion
of training by the manufacturer or. his agent for the material to be installed.
d. The tubing and fittings must be marked as required by the applicable standard specification and with
the appropriate ASTM designations by the manufacturer.
e. The installation must be in accordance with the manufacturer's installation guidelines.
5. If plastic pipe is used for the drain, waste and vent system:
a. PVC plastic pipe shall comply with ASTM Standard D 2665, D 2949, F 891.
b. It must be installed in accordance with Minnesota Rules, part 4715.0580(F) and part 4715.0600.
Above-grade horizontal runs of plastic waste and vent pipe cannot exceed 35 feet in total length.
Above-grade vertical stacks constructed of plastic pipe may exceed 35 feet in total height ouly if an
approved expansion joint is used.
c. Solvent weld joints in PVC and CPVC pipe must include use of a primer which is of contrasting
color to the pipe and cement (see Minnesota Rules, part 4715.0810, subpart 2).
6. The plumbing system shall be tested in accordance with Minnesota Rules, part 4715.2820.
7. The water piping system shall be disinfected in accordance with Minnesota Rules, part 4715.2250.
Upon completion/verification of these items, please contact Mr. Charles Olson at 651/215-0856 for a
plumbing inspection. lfyou have any questions, please contact me at 6511215-0853.
Sincerely,
~4 ~25L-
Bradley C. Erickson
Public Health Engineer
Environmental Health Services Section
P.O. Box 64975
St. Paul, Minnesota 55164-0975
BCE:sas /
cc: City of Albertville
Charles Olson
Valley Plumbing Company, Inc.
Miscellaneous
Plan No. 054197
Page 2
June 22, 2005
b. The system must be installed by a plumber trained by the manufacturer of the particular PBX system
to be installed. Certain manufacturers require installation by licensed plumbers who have been
trained to install their material.
c. All persons installing PBX materials shall have a card on thei;r possession documenting completion
of training by the manufacturer or. his agent for the material to be installed.
d. The tubing and fittings must be marked as required by the applicable standard specification and with
the appropriate ASTM designations by the manufacturer.
e. The installation must be in accordance with the manufacturer's installation guidelines.
5. If plastic pipe is used for the drain, waste and vent system:
a. PVC plastic pipe shall comply with ASTM Standard D 2665, D 2949, F 891.
b. It must be installed in accordance with Minnesota Rules, part 4715.0580(F) and part 4715.0600.
Above-grade horizontal runs of plastic waste and vent pipe cannot exceed 35 feet in totallengtb.
Above-grade vertical stacks constructed of plastic pipe may exceed 35 feet in total height ouly if an
approved expansion joint is used.
c. Solvent weld joints in PVC and CPVC pipe must include use of a primer which is of contrasting
color to the pipe and cement (see Minnesota Rules, part 4715.0810, subpart 2).
6. The plumbing system shall be tested in accordance with Minnesota Rules, part 4715.2820.
7. The water piping system shall be disiufected in accordance with Minnesota Rules, part 4715.2250.
Upon completionlverification of these items, please contact Mr. Charles Olson at 651/215'{)856 for a
plumbing inspection. If you have any questions, please contact me at 6511215'{)853.
Sincerely,
~J4 ('2.5L-
Bradley C. Erickson
Public Health Engineer
Environmental Health Services Section
P.O. Box 64975
St Paul, Minnesota 55164.{)975
BCE:sas /
cc: City of Albertville
Charles Olson
~l?.~l'!tlL€
Fax Coversheet
City of Albertville
5975 Main Avenue N.E.
P.O. Box 9
Albertville, MN 55301
Building Department
Phone: 763.497.5106
Fax: 763.497.3210
email: Jsutherland@ci.albertville.mn.us
TO:
Df~VE> H-&VJ ~ L
(. pp f-
CoWl/Nt tE:AJ;f"t:/L P'LA)IVt~IA11r.
(P~1-'Z>5"- 4~ PHONE: 15~5
COMPANY:
REGARDING:
FAX:
FROM:
Jon Sutherland. Building Official
PAGE:
lof3
li/( 1.1[05
DATE:
PZOSE:
_ For your information _ Take appropriate action
_ As you requested
Review and return As we discussed
_ Reply to sender
_ For your approval _ Other (see remarks)
REMARKS:
Cf\<;L -j'D .D(Stl77::> PL6f1?.s:-,
11-l-A1b1 !
.
~t(u
I\1b t. BUILDING PERM!. T APPLICATION
~r V 1 ~ 5975 Main Avenue
,.. ,.. Albertville, MN 55301
Small Town Uvlng. 81g 0Iy Ufe.
. _ _ _ _ _ _ _ _~. _ ~ _ _ _ _ ~~o~e~7~::~:.1~~_F~7;~97-:0:8_ ~_
Site.Address: \ 6~a~ lJ
Busmess Name: . 7 r
The Applicant is: Owner Contractor Tenant
Legal Description:
Addition
Lot
Block
Owner:
Name
Address
City
St_ Zip
Phone (H)
(W)
(C)
Address
St_ Zi~~
,rn~
Contact Person
(Other)
Architect:
Name
Address
.
City
St_ Zip
Phone (W)
(C)
(Other)
Type of Work:
D New Construction Residential D Addition
D New Construction Commercial D Garage/Shed
D Tenant Finish D Comm Plbg
Description of Work: 3 P'1:'
D Alteration
D Reside/Reroof
D Comm Htg
D Finish Bsmt
D Fireplace
D Deck
Size of Structure:
Length
Width
Height
Total Square Footage:
First Floor
Second Floor
Basement
Garage
Estimated Valuation of Work:
t tx:O (~
I
I
I
I
I
I
I
Date I
---------------1
Separate permits are required for electrical, plumbing, heating, ventilation or air conditioning.
I hereby certify that I have read and examined the application and understand that all work which is being peiformed shall comply
with the approved plans and specifications submitted. All provisions of 1m vs and ordinances governing this typ~o work will be
complied with whether specified herein or not. _ " I 0
r. ,,~
pproved by Building Official
. Special Conditions or Comments:
Value Approved
Date
BUILDING PERMIT FEES
Permit
Surcharge .50
Plan Check
Engineering (site)
Mechanical
Fireplace (s) as/Do
Plumbing
S&W
Water Meter
WAC
SAC
Storm Water
License Check
Other 1taG. q) /
V
TOTAL
Type of Const.
Use of Bldg
Occupancy Group
Occupancy Load
Zoning
Are Fire Sprinklers Required?
DYes DNo
Special Approvals
Date Approved
Fire Dept. -
City Engineer -
City Planner -
Public Works -
Other -
White - City
Pink - Customer
Yellow - File
Blue - County Assessor