Page 60 - 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 Family practice and mini lab (Suite 235) Floor/Bldg 2 Floor Med Plaza
nd

Zone Valve Location for this Area Hallway outside mini lab ZVB Manufacturer Ohmeda

FL Hosp. Tag # MA-P-5PN-02-B-Z-W-02/VAC-P-5PN-02-B-Z-W-02
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge AIR VAC
Pressure vs.
ZVB Gauge 50 25

Valve Size
Comments:

Gas/Pipeline Purity Med Air Comments
Hydrocarbons Zone is not in use. Alarm panel is also turned off.
Dew Point
Carbon Monoxide
Carbon Dioxide
Gas Concentration

Particulates
Odor/Discoloration

Test Location Mini lab

Area Alarm Panel Location for this Area Hallway

Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Hill rom Med Plus (GP-L-5PC-02-2G-Z02)
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
AIR 40 60
VAC 12 -
PS= Patient Side SS= Source Side NW= Not Working CNT= Could Not Test NA = Not Applicable NP = Not Present

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