“Access to Safe, Quality Healthcare Environments that Meet

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-0471-13

OSHPD Preapproval of Manufacturer’s Certification (OPM)

Type: New Renewal Update to Pre-CBC 2013 OPA Number: OPA-1311

Manufacturer Information

Manufacturer: Aladdin Temp-Rite LLC

Manufacturer’s Technical Representative: Michael Hobkirk

Mailing Address: 250 E. Main Street, Hendersonville, TN 37075

Telephone: (615) 537-3780 Email: mhobkirk@aladdin-atr.com

Product Information

Product Name: Convect-Rite III Docking Station plus Cart

Product Type: Rethermalization refrigerator unit with cart

Product Model Number: Docking Station: CR3DS2, CR3DS0, CR3DS1; Cart CR3C24xxx, CR3C30xxx

General Description: Rethermalization docking station for meal carts to retherm meals prior to distribution to patients. The docking station provides the controls for consistent convected refrigeration and heat as required of meals in cart.

After rethermalization, the insulated Convect-Rite III cart is then disengaged and serves as the meal delivery cart.

Applicant Information

Applicant Company Name: Aladdin Temp-Rite LLC

Contact Person: Michael Hobkirk

Mailing Address: 250 E. Main Street, Hendersonville, TN 37075

Telephone: (615) 537-3780 Email: mhobkirk @aladdin-atr.com

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: 2/6/18

Title: Manager of Customer Support Services Company Name: Aladdin Temp-Rite LLC

10/03/2018 OPM-0471-13: Reviewed for Code Compliance by Jeffrey Kikumoto Page 1 of 7

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“Access to Safe, Quality Healthcare Environments that Meet

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: Degenkolb Engineers

Name: Chad Closs California License Number: S5946

Mailing Address: 225 Broadway Suite 1325, San Diego, CA 92101

Telephone: (619) 814-7012 Email: ccloss@degenkolb.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 1950-16

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: 10-03-2018

Print Name: Jeffrey Kikumoto

Title: SSE

Condition of Approval (if applicable):

10/03/2018 OPM-0471-13: Reviewed for Code Compliance by Jeffrey Kikumoto Page 2 of 7

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