Page 32 - 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 Nuclear Medicine Floor/Bldg 1 Floor Med Plaza
st

Zone Valve Location for this Area Corridor wall next to Nuc Med ZVB Manufacturer Amico

FL Hosp. Tag # O2 #000000234064 AIR #000000234063 VAC #000000234065
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 49 -24

Valve Size 1/2 1/2 1
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 Nuc Med Nuc Med

Area Alarm Panel Location for this Area In nurse’s station

Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Amico LCD #000000234067
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 50 40 60 P P P PS PASS
VAC 25 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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