oshpd preapproval of manufacturer's certification (opm) · william staehlinwwilli stwilliam...
TRANSCRIPT
“Access to Safe, Quality Healthcare Environments that Meet California’s Diverse and Dynamic Needs”
OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION
STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCYOSH-FD-700 (REV 12/16/15) Page 1 of 2
APPLICATION FOR OSHPD PREAPPROVAL OF MANUFACTURER’S CERTIFICATION (OPM)
OFFICE USE ONLY
APPLICATION #: OPM-0375-13
OSHPD Preapproval of Manufacturer’s Certification (OPM)
Type: New Renewal Update to Pre-CBC 2013 OPA Number:
Manufacturer Information
Manufacturer: Plexus
Manufacturer’s Technical Representative: Daniel Schraufnagel
Mailing Address: 55 Jewelers Park Drive, Neenah, WI. 54956
Telephone: On File Email: On File
Product Information
Product Name: Cerner RX Station
Product Type: Other Electrical & Mechanical Elements
Product Model Number: N/A
General Description: Automated Medication Dispensing Cabinet
Applicant Information
Applicant Company Name: EASE Co.
Contact Person: Jonathan Roberson, S.E.
Mailing Address: 5877 Pine Ave. Suite 210, Chino Hills, CA. 91709
Telephone: (909) 606-7622 Email: [email protected]
I hereby agree to reimburse the Office of Statewide Health Planning and Development review fees in accordance with the California Administrative Code, 2016.
Signature of Applicant: Date: 8/29/16
Title: Principal Engineer Company Name: EASE Co.
ddii
c
cc
c
c
h
aa
h
aa
a
aa
a
tt
n
i
nc cc ch ah aa
d D
la
d D
n
ic D
En
c i
E
ca
E
aat
ec
ti
ec ma ma ml eeE e
D
E
D
E n
D
l n
i
te se
E
s
E
mm
mm
m
mm
e
mm
C
e
aa
C
e
a
C
n
i
n
l
t
:
i
s
b
s
b
s
E
i
Emm
C
m O
C
m O
C
a
t
aai
bb
:
i t
OO
ical Elementsnical Elements
on Dispensing Cabinetion Dispensing Cabinet
nah, WI. 54956
Email: On File
on
& Mec
ed Med
M
enah, WI. 54956
o
&
ed
Email: On
c
d
& MMe
n
O Filee
M
William Staehlin
OPM-0375-13
10/05/2017g/ /
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 1 of 14
“Access to Safe, Quality Healthcare Environments that Meet California’s Diverse and Dynamic Needs”
OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION
STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCYOSH-FD-700 (REV 12/16/15) Page 2 of 2
Registered Design Professional Preparing Engineering Recommendations
Company Name: EASE Co.
Name: Jonathan Roberson, S.E. California License Number: S4197
Mailing Address: 5877 Pine Ave. Suite 210, Chino Hills, CA. 91709
Telephone: 909-606-7622 Email: [email protected]
OSHPD Special Seismic Certification Preapproval (OSP)
Special Seismic Certification is preapproved under OSP-(Separate application for OSP is required)
Special Seismic Certification is not preapproved
Certification Method(s)
Testing in accordance with: ICC-ES AC156 FM 1950-16
Other* (Please Specify):
*Use of criteria other than those adopted by the California Building Standards Code, 2016 (CBSC 2016) for component supports and attachments are not permitted. For distribution system, interior partition wall, and suspended ceiling seismic bracings, test criteria other than those adopted in the CBSC 2016 may be used when approved by OSHPD prior to testing.
Analysis
Experience Data
Combination of Testing, Analysis, and/or Experience Data (Please Specify):
List of Attachments Supporting the Manufacturer’s Certification
Test Report Drawings Calculations Manufacturer’s Catalog
Other(s) (Please Specify):
OFFICE USE ONLY – OSHPD APPROVAL VALID FOR CBC 2016 & ALL PRE-2016 CODE BASED PROJECTS
Signature: Date: 10-05-2017
Print Name: William Staehlin
Title: SSE
Condition of Approval (if applicable):
aammn
meme
nmeme
idid
tt
dt
d
tttthehehh
beb
/
oo
beb
o
y
o
yem
r
ema
tdman
h
E
dit
n
h
E
E
tn
e
S
E
bt
t
e
S
x
be
th
e
S
x
be
th
pp
dh
y the C
A
pp
o
y the C
A
e
the C
C
e
the Ca
C
ee
he Ca
C
rrd
he Cal
E 1
ii/
e Cali
E 1
eo e
e Calif
S 5
eo e
e Califo
S 5
r
Califo
S 66
nr
Califor
6
E n
Califor
A
E c
Californ
A
E c
aliforn
A
x
aliforni
C
x
alifornia
C
xp
lifornia
C
p
fornia
pe
fornia
1
e
ornia B
e
ornia B
5
r
rnia B
5
ri
rnia Bu
6
e
nia Bu
6
e t
nia Bui
6
n a
ia Build
n a
a Build
F
n a
a Build
FF
c
a Buildi
F
c
Buildin
M
Buildin
M
Building
M
Building
uilding uilding S
1
(
uilding S
1
P
ilding S
9
P
lding St
9
Pt
ding Sta
5
lla
ding Sta
5
ea
ing Stan
50
e
ng Stan
0
a
ng Stand
0F
a
ng Stand
-F
a
g Standa
M 1
s
g Standa
M 1
s
Standa
M
( e
Standar
M
e
Standard
P e
Standard
1
P
tandardss
1
l S
tandardss
9
e S
pandards
9
e
app
andards CC
9
ase Sp
appa
ndards CC
5
a
yaaCndards C
5
s
yyaa
dards Coo
0
s
y rrt
dards Co
0
e
bbrtti
dards Cod
-
e
bbtit
a
-
bet
a
1
S
ee
r
S
e
rd
S
dds
a
spapy
Cay
CaCrb
orb
ote
oiet
ce DataD tae Dace
th C lif i B ildi St d dd. For distribution system, interior ose adopted in the CBSC 2016 mse
y gd. For distribution system, interior o ase add
9ICC-ES 16
adopted by the California Building Standards Code, 20ot permitted. For distribution system, interior partition waher tha used
sis, and/o Specify):
Manufacturer’s Certificationcturer’s C
an
doadopted by the California Building Standards Code, 20ot permitted. For distribution system, interior partition wah d
sis ):
Manufacturer’s Certification
l i
ES 0 16
ted by the California Building Standards Codrmitted. For distribution system, interior partita e
d/o Sp
er t use
dop
ICCC E 66
e, 2
s aan
actturrer s CCertific ti
William Staehlindistribution system, interiodistribution system, interioopted in the CBSC 201opted in the CBSC 20166 mm
OPM-0375-13OPM 0375 13
10/05/2017
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 2 of 14
William StaehlinWiillliamm SStaaehhliinn
OPM-0375-13
10/05/2017
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 3 of 14
212
William StaehlinWWWiilllliiaamm SStttaae
OPM-0375-13OOPM-0337755--
10/05/2017
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 4 of 14
123
William StaehlinllialliaWilliam Staaa aill aaam aaaaaaaaWWi m Sm StaStaaam S ai aam aamal ail aam aWi aSSS eh n
OPM-0375-13037503757O 0 7777777000000337 -00 -00 77300 -03333777777777777777 --00 7777703750375777
10/05/201710/05/20170 11
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 5 of 14
412
William StaehlinllllW SS lliiia hll aaalll hlWilli St liSl hlaeaehlWilliam Sta liaehlhaehl naehlaehlllllllaehl naehlaehl nnStaehlinliam SWilll SSS iie llliiilhliliiW aeaaeaeaeaeehlhhllhlhlhlhlhh inilliSl lllililillilllllllllllllllll SSSSSSSSSSS ll aW lll a
OPM-0375-135
10/05/2017/// 20202000
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 6 of 14
512
William StaehlinllllW SS lliiia hll aaalll hlWilli St liSl hlaeaehlWilliam Sta liaehlhaehl naehlaehlllllllaehl naehlaehl nnStaehlinliam SWilll SSS iie llliiilhliliiW aeaaeaeaeaeehlhhllhlhlhlhlhh inilliSl lllililillilllllllllllllllll SSSSSSSSSSS ll aW lll a
OPM-0375-135
10/05/2017/// 20202000
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 7 of 14
612
William Staehlinaam Sam SWilliam StaehltWWWWWWWW iaaaa ttt liW iiWW liWilliaWil aetaehlehliitae lW aaa ttt lta ta lWW aa tt lW l iaW eeeh i
OPM-0375-135-135 135 1311- 5 111111115555555 1155555 11555-11111111155 111115-1355 13111
10/05/201705/000 //// 00 7701/0010 77///////////////////////////////////////////// //222222222222222222222222222222225
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 8 of 14
712
William Staehlinaeeee nehehhhhhllinW eaehlia lehllh nnnininnnnl
OPM-0375-13OPM 0375 135
10/05/2017/
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 9 of 14
812
William Staehlinlll iam SSttaaeehhliiinnlllliamm SSttaaehhlinn
OPM-0375-13O 003333377555 133
10/05/2017
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 10 of 14
912
William StaehlinS iii
OPM-0375-133
10/05/2017
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 11 of 14
1012
William Staehlinn
OPM-0375-13O
10/05/2017/ /
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 12 of 14
1112
William StaehlinS
OPM-0375-13
10/05/2017
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 13 of 14
1212
William Staehline
OPM-0375-13O 03 5 30
10/05/2017
10/05/2017 OPM-0375-13: Reviewed for Code Compliance by William Staehlin Page 14 of 14