Page 20 - Med Plaza and Cancer Center

ZONE VALVE/ AREA ALARM / OUTLET PERFORMANCE/GAS CONCENTRATION AND PURITY INSPECTION DOCUMENT

Facility Florida Hospital Orlando-Med Plaza Inspector Steve Gourley
City/State Orlando, FL Date 11-30-17 Page 1 of 2
Contractor n/a Facility Contact Darrell Huckaby

Area Served 3T MRI Floor/Bldg 1 Floor Med Plaza
st

Zone Valve Location for this Area Corridor wall across from gen. waiting area. ZVB Manufacturer Medaes

FL Hosp. Tag # O2/MA/VA-P-5PN-01-B-Z-W-06
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge O2 52 AIR 49 VAC -25
Pressure vs.
ZVB Gauge 53 45 -26

Valve Size 1/2 1/2 3/4
Comments:

Gas/Pipeline Purity Oxygen Med Air Comments
Hydrocarbons <1 PPM <1 PPM
Dew Point -46 23
Carbon Monoxide <1 PPM <1 PPM
Carbon Dioxide <1 PPM 370 PPM
Gas Concentration 99.9%O2 21.0 (%O2)
Particulates <1 <1

Odor/Discoloration None None
Test Location 3T MRI 3T MRI

Area Alarm Panel Location for this Area Corridor wall next to ZVB

Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Amico Alert (GP-L-5PN-01-3G-004)
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
OXY 53 40 60 P P P PS PASS
AIR 50 40 60 P P P PS PASS
VAC 23 12 - P P P PS PASS
PS= Patient Side SS= Source Side NW= Not Working CNT= Could Not Test NA = Not Applicable NP = Not Present

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