Page 48 - 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 Recovery Beds 6-9 Floor/Bldg 1 Floor Med Plaza
st

Zone Valve Location for this Area Outside recovery beds 6-9 ZVB Manufacturer Beacon

FL Hosp. Tag # (O2/Air) #000000227014, (N2O/VAC) # 000000227016
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge O2 52 AIR 49 VAC 28 N2O N/A
Pressure vs.
ZVB Gauge 53 51 28 N/A

Valve Size 3/4 1/2 11/2 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/Light None/Light
Test Location Bed 7 Bed 7

Area Alarm Panel Location for this Area In nurse’s station for beds 6-9
Location IAW NFPA 99 Pass Labeled Fail Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Ohio black face (GP-L-5PS-01-4G-002)
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
OXY 53 40 60 P P P PS Normal light is out. Pass
AIR 51 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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