Page 46 - 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 PET CT Scan Room Floor/Bldg 1 Floor Med Plaza
st

Zone Valve Location for this Area Corridor wall next to PET/CT ZVB Manufacturer Amico

FL Hosp. Tag # O2 #000000234061 AIR #000000234060 VAC #000000234062 N2O #000000234059
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge O2 52 AIR 49 VAC 24 N2O 52
Pressure vs.
ZVB Gauge 51 50 26 52

Valve Size 1/2 1/2 1 1/2
Comments:

Gas/Pipeline Purity Oxygen Med Air N2O Comments
Hydrocarbons <1 PPM <1 PPM <1 PPM
Dew Point -46 23 -27
Carbon Monoxide <1 PPM <1 PPM <1 PPM
Carbon Dioxide <1 PPM 370 PPM <1 PPM

Gas Concentration 99.9%O2 21.0 (%O2) 99.9% N2O
Particulates <1 <1 <1
Odor/Discoloration None None None

Test Location PET/CT PET/CT PET/CT

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 Amico LCD #000000234066
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 50 40 60 P P P PS PASS
VAC 24 12 - P P P PS PASS
N2O 52 40 60 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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