“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 AGENCY OSH-FD-700 (REV 12/16/15) Page 1 of 2
APPLICATION FOR OSHPD PREAPPROVAL OF MANUFACTURER’S CERTIFICATION (OPM)
OFFICE USE ONLY
APPLICATION #: OPM-0369-13
OSHPD Preapproval of Manufacturer’s Certification (OPM)
Type: New Renewal Update to Pre-CBC 2013 OPA Number:
Manufacturer Information
Manufacturer: Omnicell, Inc.
Manufacturer’s Technical Representative: Chris Muir
Mailing Address: 590 E. Middlefield Road, Mountain View, CA 94043
Telephone: (650) 251-6329 Email: [email protected]
Product Information
Product Name: Half Height Cabinet
Product Type: Automated Medication Dispensing Cabinets
Product Model Number: MED-FRM-102, -103, -104, -020, -021, -029, -039
General Description: Medication storage and dispensing cabinets.
Applicant Information
Applicant Company Name: Omnicell, Inc.
Contact Person: Chris Muir
Mailing Address: 590 E. Middlefield Road, Mountain View, CA 94043
Telephone: (650) 251-6329 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: 06/02/2017
Title: Engineer Company Name: Omnicell, Inc.
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OPM-0369-13
01/19/2018g/ /
01/19/2018 OPM-0369-13: Reviewed for Code Compliance by Jeffrey Kikumoto Page 1 of 9
“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 AGENCY OSH-FD-700 (REV 12/16/15) Page 2 of 2
Registered Design Professional Preparing Engineering Recommendations
Company Name: Degenkolb Engineers
Name: Adrian M. Nacamuli California License Number: S 4857
Mailing Address: 1300 Clay Street, Suite 900, Oakland, CA 94612
Telephone: (510) 250-1216 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 1950-15
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: 01-19-2018
Print Name: Jeffrey Kikumoto
Title: SSE
Condition of Approval (if applicable):
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01/19/2018
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