Page 30 - 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 MRI Holding 1 & 2 Floor/Bldg 1 Floor Med Plaza
st

Corridor wall outside of MRI
Zone Valve Location for this Area Unit ZVB Manufacturer Amico

FL Hosp. Tag # O2 #000000234088 AIR #000000234087 VAC #000000234089
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge O2 52 AIR 49 VAC 25
Pressure vs.
ZVB Gauge 52 50 24

Valve Size 1/2 1/2 11/4
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 MRI Hold 2 MRI Hold 2

Area Alarm Panel Location for this Area Wall outside of holding 1
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Amico LCD #000000222695
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
OXY 51 40 60 P P P PS PASS
AIR 49 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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