Page 42 - 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 PEDS 9-12 & PACU 1-2 Floor/Bldg 1 Floor Med Plaza
st

Zone Valve Location for this Area Wall across from PEDS 8 ZVB Manufacturer Beacon

FL Hosp. Tag # O2/MA/VA-P-5PN-01-B-Z-W-01
Location IAW NFPA 99 Pass Labeled Fails Gauges Pass Leak Test Pass
Test Gauge O2 52 AIR 49 VAC 21
Pressure vs.
ZVB Gauge 52 51 21

Valve Size 3/4 3/4 11/4
Comments: ZVB cover tags read Patient Rms 9 thru 12 & PACU 1&2; Tags inside ZVB on piping read Patient Rms 1
thru 6, 13 & 14

Gas/Pipeline Purity Oxygen Med Air Comments
Hydrocarbons <1 PPM <1 PPM
Dew Point -29 -15
Carbon Monoxide <1 PPM <1 PPM
Carbon Dioxide <1 PPM 250 PPM
Gas Concentration 99.9%O2 21.0 (%O2)

Particulates >1 <1
Odor/Discoloration None None
Test Location PEDS 10 PEDS 10

Area Alarm Panel Location for this Area Nurses station across from PEDS 2
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Beacon Mega 2 GP-L-5PN-01-3G-001
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
OXY 52 40 60 P P P PS PASS
AIR 49 40 60 P P P PS PASS
VAC 24 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

Corporate Office ∙ 4518 Clements Rd. Lakeland Florida 33811 Phone: 863-646-7555 ∙ Fax 863-646-2999
“Medical Gas Pipeline Equipment Service, Sales & Verifications”
©Daniel Voight 2009