Page 2 - 2017 Disc Rep FSRs Med Plaza Cancer Ctr
P. 2
FIELD SERVICE REPORT
Facility FHO Med Plaza/Cancer Center Date 2-26-18
Address 601 E Rollins St. Technician Anthony Voight/Gage Stephens
City/State Orlando FL PO# 3442460
Facility Contact/Supervisor Darrell Huckaby Department Engineering
Phone# 352-613-0549 Fax# Email Darrell.Huckaby@flhosp.org
Equipment Description 2017 Discrepancy Repairs
Equipment Manufacturer(s)
Model #/ Part # /Ser #
Equipment Location (s) Med Plaza/Cancer Center
Description of work performed Discrepancy Repairs from 2017 Annual Med Gas Inspection: #’s 4, 8, 9,
10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36 & 37.
Parts Used:
Hours: Qt. 2863 Per Diem: Mileage: Rate:
Comments & Recommendations
Signature of Service Technician Anthony Voight
Signature of Responsible Facility Authority
Corporate Office ∙ 4518 Clements Rd. Lakeland Florida 33811 Phone: 863-646-7555 ∙ Fax 863-646-2999
“Medical Gas Pipeline Equipment Service, Sales & Verifications”
www.medgaspro.org
