OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION

“Access to Safe, Quality Healthcare Environments that Meet California’s Diverse and Dynamic Needs”

STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY OSH-FD-700 (REV 10/22/14) Page 1 of 2

APPLICATION FOR OSHPD PREAPPROVAL OF MANUFACTURER’S CERTIFICATION (OPM)

OFFICE USE ONLY

APPLICATION #: OPM-0181-13

OSHPD Preapproval of Manufacturer’s Certification (OPM)

Type: New Renewal Update to Pre-CBC 2013 OPA Number:

Manufacturer Information

Manufacturer: Labconco Corporation

Manufacturer’s Technical Representative: Kevin Gilkison

Mailing Address: 8811 Prospect Avenue Kansas City, MO 64132

Telephone: (800) 821-5525 Email: KGilkison@labconco.com

Product Information

Product Name: Purifier Logic+ Class II Biosafety Cabinets

Product Type: Type A2 and Type B2

Product Model Number: Series 3023, 3024, 3025, 3026, 3034, 3036

General Description: Biological Safety Cabinets on base stands

Applicant Information

Applicant Company Name: Labconco Corporation

Contact Person: Kevin Gilkison

Mailing Address: 8811 Prospect Avenue Kansas City, MO 64132

Telephone: (800) 821-5525 Email: KGilkison@labconco.com

I hereby agree to reimburse the Office of Statewide Health Planning and Development review fees in accordance with the California Administrative Code, 2013.

Signature of Applicant: Date: 01/07/2015

Title: VP – President – Sales Engineering Company Name: Labconco Corporation

01/25/2016 OPM-0181-13: Reviewed for Code Compliance by William Staehlin Page 1 of 7

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01/25/2016/ /

OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION

“Access to Safe, Quality Healthcare Environments that Meet California’s Diverse and Dynamic Needs”

Registered Design Professional Preparing Engineering Recommendations

Company Name:

Eclipse Engineering, Inc.

Name: Chad Taylor, S.E. California License Number: S5479

Mailing Address: 113 W Main, Ste. B Missoula, MT 59802

Telephone: (406) 721-5733 Email: ctaylor@eeimt.com

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 1950-10

Other* (Please Specify):

*Use of criteria other than those adopted by the California Building Standards Code, 2013 (CBSC 2013) 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 2013 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 2013 ONLY

Signature: Date: 01/25/2016

Print Name: William Staehlin

Title: SSE

Condition of Approval (if applicable):

STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY OSH-FD-700 (REV 10/22/14) Page 2 of 2

01/25/2016 OPM-0181-13: Reviewed for Code Compliance by William Staehlin Page 2 of 7

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